标题：脑梗死急性期患者氯吡格雷抵抗与疗效的相关性

      作者：程国辉，李文东，李如成，钱剑宁，谭婵娟    (肇庆市广宁县人民医院脑科，广东 肇庆 526300)

      卷次： 2018年29卷11期

      【摘要】 目的 探讨脑梗死急性期患者氯吡格雷抵抗与疗效及近期预后的关系。方法 选择2017年1~10月期间广宁县人民医院脑科收治的142例脑梗死急性期患者为研究对象，所有患者均接受氯吡格雷治疗，将血小板聚集率降低程度<10%者纳入观察组(n=48)，≥10%者纳入对照组(n=94)。比较两组患者的临床疗效及随访3个月时缺血性血管事件发生率、改良Rankin量表(mRS)评分。结果 观察组患者的治疗总效率为 52.08%，明显低于对照组的 74.47%，差异有统计学意义(P<0.05)；随访 3个月，观察组患者的缺血性血管事件发生率为 56.25%，明显高于对照组的 26.60%，且mRS评分为(1.98±0.42)分，明显高于对照组的(1.27±0.34)分，差异均有统计学意义(P<0.05)。结论 氯吡格雷抵抗可明显影响脑梗死急性期患者的临床疗效及近期预后。在脑梗死急性期应用氯吡格雷治疗过程中，应重视血小板聚集率的检测。
      【关键词】 脑梗死急性期；氯吡格雷抵抗；预后；疗效
      【中图分类号】 R743.33 【文献标识码】 A 【文章编号】 1003—6350（2018）11—1581—03

Correlation of clopidogrel resistance and curative effect in patients with acute cerebral infarction.
CHENGGuo-hui, LI Wen-dong, LI Ru-cheng, QIAN Jian-ning, TAN Chan-juan. Department of Brain, Guangning People'sHospital, Zhaoqing 526300, Guangdong, CHINA
【Abstract】 Objective To investigate the relationship between clopidogrel resistance and efficacy, short-termprognosis in patients with acute cerebral infarction. Methods A total of 142 patients with acute cerebral infarction treat-ed in our hospital from January 2017 to October 2017 were enrolled in this study. All patients were treated with clopido-grel, and the reduction rate of platelet aggregation rate was measured: patients with reduction rate<10% were included in-to the observation group (n=48), and patients with reduction rate≥10% were included into the control group (n=94). Theclinical efficacy, the incidence of ischemic vascular events, and the modified Rankin scale (mRS) score were comparedbetween the two groups after 3 months of follow-up. Results The effective rate of the observation group was 52.08%,significantly lower than 74.47% in the control group (P<0.05). After 3 months of follow-up, the rate of ischemic vascularevents, the mRS score were 56.25%, (1.98±0.42) in the observation group, versus 26.60%, (1.27±0.34) in the controlgroup (P<0.05). Conclusion Clopidogrel resistance can significantly affect the clinical efficacy and short-term progno-sis of patients with acute cerebral infarction. In the treatment of acute cerebral infarction with clopidogrel, attentionshould be paid to the detection of platelet aggregation rate.
      【Key words】 Acute cerebral infarction; Clopidogrel resistance; Prognosis; Curative effect·临床经验·doi:10.3969/j.issn.1003-6350.2018.11.030基金项目：广东省肇庆市科技计划项目(编号：201704030720)