ABSTRACT
Objective To compare the effects of aspirin and clopidogrel on platelet aggregation function by TEG,and to study the antiplatelet agents tailored therapy of Thrombelastography(TEG)in treatment of cerebral infarc-tion patients.Methods 100 patients with acute cerebral infarction were included in two groups:aspirin group and clopidogrel group.The inhibitory rates of AA and ADP receptor pathway in platelets were detected by TEG.The effect of inhibitory rates in group aspirin and clopidogrel was compared with nerve function and the recurrence rate of stroke. Results The inhibitory rates of group aspirin (85.23 ±21.98)% was higher than group clopidogrel (47.31 ± 22.37)% (t =7.340,P =0.005).The patients with which the inhibitory rates showed goodby TEG in group aspirin and clopidogrel got better neurological recovery,and the patients showed goodby TEG in group aspirin got lower stroke recurrence rate within 1 year(χ2 =4.460,P =0.035;χ2 =7.232,P =0.007).Conclusion TEG had guided the antiplatelet individual therapy for cerebral infarction patients,and can be used to predict and confirm the efficacy of antiplatelet drug.
ABSTRACT
Objective To investigate the prognostic value of plasma brain natriuretic peptide (BNP) in patients with acute cerebral infarction. Methods Sixty-five patients with first-ever acute cerebral infarction and 32 healthy controls were recruited. The neurological deficits in patients with cerebral infarction were evaluated by using Chinese Stroke Scale (CSS).Plasma BNP levels were detected by immunofluorescence technique. Death and recurrent stroke events were followed up. Plasma BNP levels were compared between an event group and a non-event group, and the relationship between plasma BNP levels and poor prognosis was analyzed.Results Plasma BNP levels in patients with acute cerebral infarction was significantly higher than those in healthy controls (238.7 ± 131.6 pg/ml vs 38.7±23.8 pg/ml, P <0.01). Nine patients (13.8%) died, and 8 (12.3%) had nonfatal recurrent stroke during the follow-up period. Compared to the non-event group, the baseline plasma BNP levels in the death/recurrent stroke event group were significantly higher (304.0 ± 134.9 pg/ml vs 214.4 ± 120.9 pg/ml,P < 0.01). There was significant correlation between plasma BNP levels and CSS scores (r = -0.359, P <0.05). After performing multivariate analysis of various risk factors, it found that BNP levels (OR = 3.5, 95 % CI 2.1 to 5.8, P < 0.01), advanced age (OR = 4.1,95% CI 1.7 to 9.2, P <0.01) and CSS scores (OR =2.6, 95% CI 1.6 to 4.3, P <0.01)were the independent predictors of poor outcome. Conclusions The increased BNP levels are the recent death and recurrent independent predictors in patients with acute cerebral infarction.