Department of Neurology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Gordon F. Derner School of Psychology General Psychology, Adelphi University, New York, United States.
Clin Appl Thromb Hemost. 2021 Jan-Dec;27:1076029620980067. doi: 10.1177/1076029620980067.
This study aimed to investigate the long-term safety and benefits of antiplatelet therapy in patients with cerebral infarction with thrombocytopenia, as evidence regarding this was limited. This cohort trial assessed patients with acute cerebral infarction with thrombocytopenia treated in the Neurology Department of Shanghai Tenth People's Hospital from January 2016 to December 2018, and enrolled patients were followed up for 9 months. The patients were divided into non-antiplatelet and antiplatelet groups based on the actual intake of antiplatelet drugs. Primary endpoints included hemorrhagic events, recurrence of cerebral infarction, and activity of daily living (ADL) score changes. To balance baseline clinical data, propensity score matching was applied, and there were finally 65 matched patients, including 30 and 35 in the antiplatelet and non-antiplatelet groups, respectively. There were no differences in hemorrhagic and cerebral infarction recurrence rates between the 2 groups. ADL score change was higher in the antiplatelet group than in the non-antiplatelet group (10 vs 5, = 0.039). In multivariate regression analysis, antiplatelet therapy significantly predicted a positive change in ADL scores [B = 8.381, 95% confidence interval (0.56-16.19)]. In patients with acute cerebral infarction with thrombocytopenia, antiplatelet therapy could the improve the quality of life in the chronic stage.
本研究旨在探讨伴有血小板减少症的脑梗死患者抗血小板治疗的长期安全性和获益,因为这方面的证据有限。这项队列研究评估了 2016 年 1 月至 2018 年 12 月在上海第十人民医院神经内科治疗的伴有血小板减少症的急性脑梗死患者,并对患者进行了 9 个月的随访。根据实际抗血小板药物的摄入情况,将患者分为非抗血小板和抗血小板组。主要终点包括出血事件、脑梗死复发和日常生活活动(ADL)评分变化。为了平衡基线临床数据,应用了倾向评分匹配,最终有 65 例匹配患者,其中抗血小板组和非抗血小板组各有 30 例和 35 例。两组的出血和脑梗死复发率无差异。抗血小板组 ADL 评分的变化高于非抗血小板组(10 分比 5 分, = 0.039)。多变量回归分析显示,抗血小板治疗显著预测 ADL 评分的积极变化[B = 8.381,95%置信区间(0.56-16.19)]。在伴有血小板减少症的急性脑梗死患者中,抗血小板治疗可以改善慢性期的生活质量。