冠心病患者心率变异性与阿司匹林抵抗的研究

Heart Rate Variability in Patients With Stable Coronary Artery Disease and Aspirin Resistance

目的阿司匹林抵抗患者心率变异性指标的变化。方法服用阿司匹林(100 mg/d)至少7天以上的心血管患者(79例)作为入选标准。二磷酸腺苷(adenosine disphosphate,ADP)和花生四烯酸(arachidonic acid,AA)作诱导剂在Chrono-log 560 Ca上测定血小板聚集功能。记录受检者24小时动态心电图。结果阿司匹林抵抗发生率为11.4%(n=9)。阿司匹林抵抗组HRV时域参数和频域参数与阿司匹林敏感组比较均有统计学意义(P<0.01)。阿司匹林抵抗组高血压患者的比率(44.4%)与阿司匹林敏感组(25.0%)比较有显著差别(P=0.01)。结论阿司匹林抵抗组HRV时域参数和频域参数与阿司匹林敏感组比较均有统计学意义,这提示我们HRV下降的患者服用阿司匹林时,要定期检测血小板聚集功能,一旦发生阿司匹林抵抗,应提示这类患者要及时调整抗血小板药物,加大阿司匹林的剂量或换用其他抗血小板药物。

Objective We investigated the association between heart rate variability（HRV） and aspirin resistance.Methods Seventy-nine cardiovascular pafiens on aspirin （100 rag/d） for at least seven days were entrolled. The patients＇ platelet aggregation function were evaluated by Chrono-log 560 Ca with adenosine arachidonic acid （AA） and disphosphate （ADP）.24-hour Holter electrocardiogram of all the subjects were monitored. Results The prevalence of aspirin resistance was 11.4% （ n = 9）. There was statistical significance between aspirin resistance and HRV parameters. The ratio of hypertension patients in aspirin resistance group （44.4 % ） was higher than in aspirin sensitive group （ 25.0% ） （ P = 0.01）. Conduslon HRV parameters in aspirin resistance group was significantly compared to those in aspirin sensitive group, which suggest that the patients with decreased HRV parameters need to be measured by platelet aggregation ftmction. Onec aspirin resistance was found,this hint us that these patients need to adjust antiplatelet agents;increase aspirin dose or take other antiplatelet drug.