糖尿病对急性脑梗死患者氯吡格雷抗血小板效果的影响

Effect of diabetes on antiplatelet effect of clopidogrel in patients with acute cerebral infarction

目的分析糖尿病对急性脑梗死患者氯吡格雷抗血小板效果的影响。方法纳入2020年1月至2021年3月服用氯吡格雷的急性脑梗死患者82例,根据是否患有糖尿病分为糖尿病组32例和非糖尿病组50例。用血栓弹力图法测定患者血小板抑制率,以判断其氯吡格雷抵抗情况,并在出院后1年随访脑梗死复发情况。结果糖尿病组的氯吡格雷抵抗发生率为43.75%,非糖尿病组的氯吡格雷抵抗发生率为18.00%,差异有统计学意义(P<0.05)。随访1年内糖尿病组脑梗死复发率为12.50%,非糖尿病组脑梗死复发率为4.65%。结论糖尿病患者更容易发生氯吡格雷抵抗,选择抗血小板药物时应谨慎评估。

AIM To analyse the effect of diabetes on antiplatelet effect of clopidogrel in patients with acute cerebral infarction.METHODS A total of 82 patients with acute cerebral infarction treated with clopidogrel from January 2020 to March 2021 were enrolled.According to whether they had diabetes,they were divided into diabetes group(32 patients)and non-diabetes group(50 patients).The platelet inhibition rate of the patients was determined by thromboelastography to determine their clopidogrel resistance,and the recurrence of cerebral infarction was followed up for 1 year after discharge.RESULTS The incidence of clopidogrel resistance in the diabetes group was 43.75%,and in the non-diabetes group was 18.00%,and the difference was statistically significant(P<0.05).The recurrence rate of cerebral infarction in diabetes group was 12.50%with 1 year of follow-up,and was 4.65%in non-diabetes group.CONCLUSION Clopidogrel resistance is more likely to occur in patients with diabetes mellitus,and patients with diabetes mellitus should be carefully evaluated when choosing antiplatelet drugs.