老年冠心病患者阿司匹林抵抗的相关因素研究

Aspirin Resistance in the Elderly Patients with Coronary Artery Disease and Its Associated Clinical Factors

目的了解老年冠心病患者阿司匹林抵抗(AR)的发生率,并对其相关危险因素进行分析。方法选择246例正规服用阿司匹林(100 mg/d)超过3个月的老年冠心病患者,以花生四烯酸(AA)和二磷酸腺苷(ADP)作为诱导剂测定其静脉血中的血小板聚集功能,按结果分为AR组、阿司匹林半抵抗(ASR)组和阿司匹林敏感(AS)组,分析与AR有关的危险因素。结果 AR的发生率为14.6%(36/246),ASR的发生率为31.3%(77/246),AS的发生率为54.1%(133/246)。与AS组相比,发生AR的老年冠心病患者患糖尿病比例增高,C反应蛋白(CRP)、总胆固醇(TC)、纤维蛋白原(Fb)水平明显升高,差异有统计学意义(P<0.05)。结论 AR的发生可能与伴发糖尿病、血浆CRP、TC、Fb水平升高有关。

Objective To investigate the morbidity rate of aspirin resistance （AR） and its risk factors in the elderly patients with coronary artery disease （CAD） . Methods A total of 246 elderly CAD patients took aspirin 100 mg/d over 3 months were recruited. The platelet aggregation induced by adenosine diphosphate （ADP） and arachidonic acid （AA） was used to evaluate AR. The patients were divided into AR group, aspirin semi -resistance （ASR） group and aspirin sensitive （AS） group. The difference in clinical characteristics among above three groups and independent risk factors associated with AR were analyzed. Results The incidence of AR, ASR and AS were 14. 6% （36/246）, 31.3% （77/246） and 54. 1% （ 133/246 ）, respectively. Compared with the AS group, the proportion of patients with diabetes, C -reactive protein （CRP）, total choles- terol （TC）, fibrinogen （Fb） concentrations were increased statistically significantly in the elderly patients with CAD of the AR groups （P 〈 0.05 ） . Conclusion AR is likely correlated with diabetes mellitas, increased plasma CRP, TC, and Fb concentration.