冠心病合并糖尿病患者联合抗血小板药物抵抗的相关研究

王志军; 张鹏宇; 周建芝; 刁增利; 黄宇玲; 刘铁楠; 李海涛

doi:10.13201/j.issn.1001-1439.2016.10.004

冠心病合并糖尿病患者联合抗血小板药物抵抗的相关研究

- 1 华北理工大学附属医院心内科(河北唐山, 063000);
- 2 华北理工大学校医院内科
基金项目:
河北省卫生厅医学研究重点课题计划项目(No:20100474)

详细信息

通讯作者: 王志军,E-mail:wzj300@163.com

中图分类号: R541.4

收稿日期: 2016-04-03

修回日期: 2016-07-27

Analysis of aspirin resistance and clopidogrel resistance in patients with coronary heart disease combind with diabetes mellitus

- 1 Department of Cardiology, The Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, 063000, China;
- 2 University Hospital of North China University of Science and Technology

More Information

Corresponding author: WANG Zhijun, E-mail: wzj300@163.com

Received Date: 03 April 2016

Revised Date: 27 July 2016

摘要

摘要: 目的:分析冠心病(CHD)合并糖尿病(DM)患者阿司匹林抵抗(AR)及氯吡格雷抵抗(CR)的影响因素,评价AR、CR与主要不良心血管事件(MACE)的关系以及MACE的相关因素。方法:选择CHD患者270例,其中非DM患者136例(NDM组),DM患者134例(DM组),记录患者临床情况及心电图、超声心动图、冠脉造影等检查结果。检查血常规、凝血功能、生化指标。评价AR及CR。随访1年,记录患者MACE事件并分析其相关因素。结果:NDM组AR(33.8%︰62.7%,P<0.05)及CR(33.1%︰58.2%,P<0.05)发生率均显著低于DM组。NDM组无抵抗发生率显著高于DM组(54.4%︰22.4%,P<0.05),半抵抗(24.3%︰34.3%,P<0.05)和抵抗(21.3%︰44.3%,P<0.05)发生率显著低于DM组。无抵抗、半抵抗与抵抗患者hs-CRP、CK-MB、TG、TC、LDL-C、ApoA1、CR、UA、WBC计数、病变血管(处)、严重病变(处)等均差异有统计学意义(均P<0.05)。随访结果显示:DM组患者发生MACE事件44例(32.8%),NDM组发生MACE事件38例(27.9%)。Logistic分析显示,男性、心率、BMI、TG、LDL、双联抗血小板药物治疗抵抗是CHD合并DM患者发生MACE的影响因素。结论:CHD合并DM患者联合抗血小板治疗抵抗明显增高,药物抵抗与多种因素有关。发生药物抵抗患者MACE事件明显增加。
- 冠心病 /
- 糖尿病 /
- 阿司匹林抵抗 /
- 氯吡格雷抵抗
Abstract: Objective:To analysis influencing factors of aspirin resistance(AR)and clopidogrel resistance(CR)in patients with coronary heart disease(CHD)combined diabetes mellitus(DM),to evaluate the relationship among AR,CR and major adverse cardiovascular events(MACE)and the relevant factor of MACE.Method:One-hundred and thirty-six CHD patients without DM(NDM group)and 134 CHD patients combined with DM were included.Clinical data about ECG,echocardiography,coronary angiography,blood count biochemical indicators were collected.After 1-year follow-up,MACE events were recorded and related factors were analyzed.Result:The incidences of AR(33.8%:62.7%,P<0.05)and CR(33.1%:58.2%,P<0.05)in NDM group were significantly lower than those in DM group.The incidence of no resistance in NDM group was significantly higher than that in DM group(54.4%:22.4%,P<0.05),and the incidences of semi resistance(24.3%:34.3%,P<0.05)and resistance(21.3%:44.3%,P<0.05)were significantly lower than those in DM group.There were significant differences in hs-CRP,CK-MB,TG,TC,,LDL-C,ApoA1,CR,UA,WBC,and pathological changes in the patients with non resistance,resistance,and resistance(all P<0.05).The follow-up results showed that:44cases(32.8%)of MACE occurred in DM group,38cases(27.9%)of MACE occurred in NDM group.Logistic analysis showed that male,heart rate,BMI,TG,LDL,dual antiplatelet therapy were resistance MACE factors in patients with CHD combined with DM.Conclusion:Drug resistance of dual antiplatelet therapy is significantly increased in patients with CHD combine with DM,and drug resistance is associated with a variety of factors.MACE events in patients with drug resistance are significantly increased.
- coronary heart disease /
- diabetes mellitus /
- aspirin resistance /
- clopidogrel resistance

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