Study On Risk Factors And Adverse Consequences Of Aspirin Resistance In Patients With Acute Cerebral Infarction

Purpose:By determining the levels of urinary 11-Dehydro-Thromboxane B2（11-DH-TXB2）and creatinine in patients with acute cerebral infarction after taking an effective dose of aspirin,we can determine whether Aspirin Resistance（AR）exists and whether aspirin resistance is associated with gender,age,hypertension,diabetes,blood urea nitrogen,platelet count,mean platelet volume,and so on.To explore the independent risk factors and possible adverse consequences of aspirin resistance,guide the secondary prevention and primary prevention of aspirin resistance,and reduce the incidence and mortality of cerebral infarction in aspirin resistance patients with cerebrovascular disease risk factors.Method:The hospitalized patients with acute cerebral infarction diagnosed by head magnetic resonance imaging（MRI）and diffusion-weighted imaging（DWI）in the Department of Neurology of the first hospital of Jilin University were selected as the research objects.Urine was taken on the 8th day after admission to determine urinary 11-dehydro-thromboxane B2 and urinary creatinine.The research objects were grouped according to the ratio of urinary11-dehydro-thromboxane B2 / urinary creatinine,the ratio below 1500 was aspirin-sensitive group;the ratio above 1500 was aspirin semi sensitive group;above 5000 was aspirin resistant group.The patients with aspirin semi resistance and aspirin resistance were further grouped in the aspirin insensitive group.Collected data:（1）The general sociological attributes: name,gender,age,history of cerebral infarction,history of hypertension and diabetes,smoking history,and drinking history;（2）abdominal blood creatinine,blood urea nitrogen,glycosylated hemoglobin,triglyceride,cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,uric acid,homocysteine,folic acid,vitamin B12,platelet count,average platelet volume,thrombin time,prothrombin time,activated partial thromboplastin time,BNP D-D and other biochemical indexes were collected on the second day of admission;（3）Cerebrovascular risk factors such as cerebrovascular stenosis,slow cerebral blood flow,and recurrent cerebral infarction.The above factors were statistically analyzed by SPSS 26.0 software.Result:（1）A total of 60 patients were enrolled in this study,including 30 cases in the aspirin-sensitive group and 30 cases in Aspirin insensitive group（including aspirin resistance and aspirin semi resistance）.There were 40 males and 20 females,male: female = 2:1;The average age was 57.5 ± 13.4 years.The incidence of aspirin semi resistance was 43.3%,the incidence of aspirin resistance was 6.7%,and the incidence of aspirin insensitivity was 50%.（2）Univariate analysis showed that mean platelet volume（P=0.019）,blood urea nitrogen（P=0.009）,glycosylated hemoglobin（P=0.033）,diabetes mellitus（P=0.038）,gender（P=0.028）and recurrent cerebral infarction（P=0.03）were related to AR.（3）AR was a risk factor for recurrent cerebral infarction（P = 0.03）.（4）Binary logistic regression showed that women（P = 0.01）and blood urea nitrogen（P= 0.01）were independent risk factors for AR.Conclusion:（1）Aspirin resistance（AR）exists in some patients with acute cerebral infarction.（2）Patients with AR are more prone to recurrent cerebral infarction.（3）Female and blood urea nitrogen may be independent risk factors for AR.