Clinical Risk Factors Of Aspirin Resistance In Acute Ischemic Stroke And Distribution Of TCM Syndromes

Objective To investigate the risk factors of aspirin resistance in acute ischemic stroke and the distribution of TCM syndrome elements,and to provide treatment basis for TCM and Western medicine prevention and treatment of AR patients with ischemic stroke.Methods: 168 patients with acute ischemic stroke who were hospitaliz ed in department of Neurology,Wuhan Hospital of Integrated Tra ditional Chinese and Western Medicine from March 2021 to Decemb er 2021 were selected.All subjects received oral conventional dose of aspirin 100 mg immediately after admission,and thrombol ysis was performed 7 days later.According to the results of th romboelastogram,the patients were divided into aspirin resista nce group（AR）with 0%0.05）.There were signi ficant differences between AR group and AS group in body mass i ndex（BMI）,LDL-C（low density lipoprotein）,homocysteine（Hcy）,fasting blood glucose（FPG）,history of coronary heart disease and history of type 2 diabetes（P<0.05）.3.Binary Logistic regression analysis showed that BMI（OR: 2.551,95%CI: 1.742-3.737,P<0.05）and history of type 2 diabetes（OR: 3.651,95%CI: 1.391-9.581,P<0.05）were independent risk f actors for AR.4.The distribution frequency of syndrome elements in AR group was 53.8%,38.5%,20.5%,17.9% and 12.8%,respectively,for the 6 syndrome elements in AR group.In AS group,the frequency of 6 TCM syndrome elements from high to low were phlegm-dampness,blood stasis,internal wind,internal fire,qi deficiency and Yin deficiency,accounting for 58.9%,46.5%,44.2%,26.4%,23.3% and 15.5% respectively.There was no statistical significance in the distribution of syndrome elements between AR group and AS group（P>0.05）.The combination distribution of syndrome elem ents in the two groups was mainly two syndrome elements and thr ee syndrome elements,and there was no statistical significance in the combination distribution of syndrome elements（P>0.05）.Conclusion 1.Some patients with ischemic stroke did not achieve the expected effect after taking aspirin,and there was a certain percentage of aspirin resistance.2.BMI,LDL-C,Hcy,FPG,history of coronary heart disease and history of type 2 diabetes were risk factors for AR patients with acute ischemic stroke,and BMI and history of type 2 diabetes were independent risk factors for AR.3.The distribution of TCM syndrome elements in AR patients with acute ischemic stroke was mainly phlegm dampness,blood stasis and internal wind.Although the difference was not statistically significant compared with AS group,it also suggested that patients with phlegm dampness and blood stasis were more prone to AR.The distribution combination of syndrome elements in AR group and AS group was dominated by two syndrome elements and three syndrome elements,which indicated that the occurrence of AR was the result of the joint action of multiple syndrome elements.