阿司匹林抵抗在2型糖尿病患者心血管事件中的影响研究

Effect of aspirin resistance on cardiovascular events in non-insulin-dependent diabetes mellitus patients

目的探讨阿司匹林抵抗(AR)在2型糖尿病(T2DM)患者心血管事件中的影响。方法收集该院2006年6月至2010年9月,确诊为T2DM的患者496例,连续4周给予口服阿司匹林100mg/d,用光比浊法检测血小板聚集率,将患者分为AR组、阿司匹林半抵抗(ASR)组与阿司匹林敏感(AS)组,分别比较临床生化指标之间的差异,随访1～4年后比较发生不良心血管事件的差异。结果发生AR的占总人数的11.69%;发生ASR的占总人数的37.90%。女性在AR组与ASR组中人数较多(67.48%);AR组与ASR组患者较AS组的餐前空腹血糖高,差异有统计学意义(P<0.05);AR组糖化血红蛋白(HbA1c)、三酰甘油均高于AS组患者,差异有统计学意义(P<0.05)。3组间不良心血管事件发生率差异有统计学意义(P<0.05)。结论应对T2DM患者进行AR相关检测,推荐服用阿司匹林时应注意推荐的服用剂量,并且密切监视心血管事件的发生。

Objective To explore the effect of aspirin resistance on cardiovascular events in non-insulin-dependent diabetes melli- tus patients. Methods 496 patients with non-insulin-dependent diabetes mellitus received daily aspirin therapy （100rag/d） 4 weeks were recruited from Jun. 2006 to Sept. 2010. Platelet aggregation was measured by light transmission aggregometry. The patients were divided into three groups：aspirin resistance group, aspirin semi-resistance group and aspirin-sensitive group. The clinical bio- chemistry indications and the adverse cardiovascular events were collected. Results 11. 690% of patients were found to be resistant to aspirin therapy, and 37.90 % of patients to he aspirin semi-responders. There were 67.48 % female in aspirin resistance group and aspirin semi-responders. The preprandial glucose of group AR and ASR was higher than that of group AS（P〈0.05）. The HbA1C and TG of group AR were higher than those of group AS（P〈0.05）. There was statistically significant difference of the rate of car- diovascular events. Conclusion The measure of platelet aggregation should be taken in the diabetic mellitus patients and pay atten- tion on the dose of aspirin recommended. Particular attention is should also devote to the incidence of adverse cardiovascular events.