冠心病患者阿司匹林抵抗同血小板P-选择素的相关性研究

Correlated study of aspirin resistance and P-selectin in platelet in patients with coronary heart disease

目的探讨冠心病患者发生阿司匹林抵抗(Aspirin resistance,AR)的影响因素以及AR与血小板P-选择素的相关性。方法冠心病患者86例,服用阿司匹林(100 mg/d)至少7 d,以二磷酸腺苷(Adenosinediphosphate,ADP)为诱导剂测定血小板聚集率,以ADP诱导的血小板聚集率≥70%定义为AR,<70%为阿司匹林敏感(Aspirin sensitive,AS)。同时测定患者血小板P-选择素表达阳性率。结果AR的发生率为25.6%(22/86),AR组中血糖水平及吸烟者比例高于AS组,并有显著性差异。经Logistic回归分析显示,糖尿病和吸烟是阿司匹林抵抗的独立危险因素(P<0.05)。两组患者服药后血小板P-选择素表达有显著性差异,AR组患者服药后血小板P-选择素水平显著高于AS组(P<0.05)。结论冠心病患者阿司匹林抵抗的发生率为25.6%,糖尿病和吸烟是发生阿司匹林抵抗的独立危险因素。血小板P-选择素可作为检测阿司匹林抵抗的有效指标。

Objective To investigate the correlation between aspirin resistance （AR） and P-selectin expression in platelet in patients with coronary heart disease. Methods Eighty-six patients with coronary heart disease took aspirin 100 mg/d for 7 d. We detected platelet aggregation （PAG） induced with adenosine diphosphate （ADP） and expression of P-seleetin in platelet. We identified AR when ADP induced aggregation ≥70 %. Results 25.6% of patients showed AR. The AR was significantly correlated with blood glucose and smoking. In logistic analysis, diabetes （OR = 1. 33） and smoking （OR = 1.14） were the predictor for AR. The expression of P-seleetin was significantly higher in AR patients thaninAS[（2.84±1.35）% vs.（1.26±0.55）%,P〈0.05）.Conelusion The AR accounts for 25. 5 % of all. Inthis research, AR is likely correlated with blood glucose and history of smoking. AR patients should take more than usual dosage or alternative other anti-platelet medicine.