老年冠心病患者阿司匹林抵抗的相关因素分析

Factors associated withf aspirin resistance in senile patients with coronary heart disease.

目的探讨阿司匹林抵抗的发生率，及阿司匹林抵抗患者的临床特征，发掘出AR发生的相关因素。方法分析2007年1月～2012年1月因冠心病在我院接受治疗的患者的临床资料。比较发生阿司匹林抵抗或半抵抗组与阿司匹林敏感组在合并病史，性别，白细胞（WBC）、红细胞（RBC）、血红蛋白（Hb）、血小板计数（PLT）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL—c）、高密度脂蛋白胆固醇（HDL—c）及空腹血糖（FBG）等指标上的差异。结果215例患者中阿司匹林抵抗或半抵抗发生率为27．4％（59／215）；阿司匹林抵抗组或半抵抗组合并糖尿病的比率明显高于阿司匹林敏感组，差异具有统计学意义（P〈0．05）；女性患者抵抗率明显高于男性（49．2％，31／63vs18．4％，28／152；P〈0．05）；阿司匹林抵抗组或半抵抗组血小板计数显著高于阿司匹林敏感组，差异具有统计学意义（P〈0．05）；Logistic回归分析显示女性、合并糖尿病、血小板升高为老年冠心病患者阿司匹林抵抗的独立风险因素（P〈0．05）。结论阿司匹林抵抗现象在临床中确实存在，可能与合并糖尿病、血小板升高、性别有关。其发生抵抗的机制仍需进一步研究。

：Objective To determine the factors associated with aspirin resistance in senile patients with coronary heart disease. Methods Clinical data of coronary heart disease patients in our hospital from 2007 to 2012 were collected and the counts of WBC, PLT and levels of Hb, RBC, Hb, TC, TG, LDL-c, HDL-c, and FBG of the patients were determined in the first 24 hours of admission. Aggregation function of platelet was induced by adenosine diphosphate （ADP） and collagen （COL） was determined by the whole blood impedance. Results The rate of aspirin resistance was 27.4%（59/215）.Serum PLT, sex and glycuresis in aspirin resistance or aspirin semi-resistance group were found significantly higher than those in aspirin sensitive group in senile patients with coronary heart disease （P〈0.05）. The logistic regression analysis showed that the female sex, thrombocytosis, diabetes were the independent risk factors associated with aspirin resistance in the elderly patients with coronary heart disease（P〈0.05）. Conclusion Aspirin resistance really existed in the patients with coronary artery disease and the resistance might be associated with diabetes, enhancement of Serum PLT and sex. But the mechanism of occurrence of aspirin resistance be further investigated