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.%Objective To investigate the relationship between clopidogrel resistance and efficacy, short-term prognosis 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). The clinical efficacy, the incidence of ischemic vascular events, and the modified Rankin scale (mRS) score were compared between 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 vascular events, the mRS score were 56.25%, (1.98 ± 0.42) in the observation group, versus 26.60%, (1.27 ± 0.34) in the control group (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, attention should be paid to the detection of platelet aggregation rate.
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