老年心血管病合并高同型半胱氨酸血症患者阿司匹林抵抗发生率及危险因素调查

Aspirin resistance in elderly cardiovascular disease patients with hyperhomocysteinaemia and its risk factors

目的探讨老年心血管病患者合并高同型半胱氨酸血症（Hhcy）的阿司匹林抵抗（AR）的发生率及危险因素。方法共纳入370例老年心血管病患者,其中Hhcy患者216例（Hhcy组）,非Hhcy患者154例（对照组）,均接受常规阿司匹林治疗（≥75mg）〉1个月。阿司匹林的疗效评价采用光比浊法检测血小板聚集率,AR定义为花生四烯酸诱导的血小板聚集率≥20%。结果 Hhcy组AR发生率显著高于对照组（16.7%vs 7.8%,P=0.012）;与对照组比较,Hhcy组同型半胱氨酸和肌酐水平显著升高（P〈0.05,P〈0.01）。logistic回归分析显示,Hhcy是发生AR的独立危险因素（OR=2.406,95%CI：1.201~4.820,P=0.013）。结论老年心血管病患者合并Hhcy的AR发生率明显增加,Hhcy是老年心血管病患者发生AR的重要危险因素。

Objective To study the aspirin resistance（AR）in elderly cardiovascular disease（CVD）patients with hyperhomocysteinaemia（Hhcy）and its risk factors.Methods Three hundred and seventy elderly CVD patients were divided into Hhcy group（n=216）and control group（n=154）.The patients received conventional aspirin therapy（≥75mg）over 1month.The therapeutic effect of aspirin was assessed according to the platelet aggregation rate detected by light turbidimetry.AR was defined when the arachidonic acid-induced platelet aggregation rate was ≥20%.Results The prevalence of AR was significantly higher in Hhcy group than in control group（16.7%vs 7.8%,P=0.012）.The serum Hcy and creatinine levels were significantly higher in Hhcy group than in control group（P〈0.05,P〈0.01）.Hhcy was an independent risk factor for AR（OR=2.406,95%CI：1.201-4.820,P=0.013）.Conclusion The prevalence of AR is significantly higher in elderly CVD patients with Hhcy which is an important risk factor for AR.