老年冠心病患者阿司匹林抵抗及危险因素研究

Study of aspirin resistance and risk factors in gerontal patients with coronary artery disease

目的分析老年冠心病(CAD)患者阿司匹林抵抗(AR)的患病率及临床特征,评价AR的相关危险因素。方法129例住院老年CAD患者包括急性冠状动脉综合征(ACS)106例、稳定型心绞痛患者(SAP)23例。应用二磷酸腺苷(ADP)、花生四烯酸(AA)诱导的血小板聚集率评价AR。测定血液生化指标,记录心血管疾病危险因素,伴随临床疾病,超声心动图、冠状动脉造影结果及介入治疗措施等。结果老年CAD患者AR的患病率为51.9%,ACS组AR患病率(57.5%)明显高于SAP组(26.1%)。多因素logistic回归分析结果显示,AR与合并糖尿病、高敏C反应蛋白(hsCRP)及低密度质蛋白胆固醇(LDL-C)水平升高相关(P<0.05)。结论老年CAD患者AR患病率ACS组明显高于SAP组,合并糖尿病、hsCRP和LDL-C升高是AR的危险因素。

Objective To analyze the aspirin resistance （AR） morbidity rate and clinical feature of gerontal coronary artery disease （CAD） patients and evaluate correlated risk factors of AR. Methods 129 hospitalized gerontal CAD patients including 106 acute coronary syndrome （ACS） cases and 23 stable angina poctoris （SAP） cases were selected. The platelet aggregation of adenosine diphosphate and arachidonic acid was used to evaluate AR. Blood biochemical indicator, concomitance risk factors and diseases, ultrasonic echocardiagram, coronary arteriongraphy results, intervenfional therapy were measured and recorded. Results The AR morbidity rate of study population was 51.9%. The AR of ACS group （57.5%） exceeded that of SAP （26.1%） with significant differences. Multiple factor logistic regression analysis demon- strated AR of the group correlated with diabetes, hsCRP and LDL-C. Conclusions ACS group has more increased AR than SAP group in gerontal CAD patients. Diabetes, high level of hsCRP and LDL-C are risk factors of AR.