急性冠状动脉综合征患者氯吡格雷抵抗与生长分化因子15的相关性分析

An analysis of correlation between clopidogrel resistance and growth differentiation factor-15 in patients with acute coronary syndrome

目的探讨急性冠状动脉综合征(ACS)患者氯吡格雷抵抗与生长分化因子15(GDF-15)之间的相关性。方法采用ELISA法检测245例ACS患者的血清GDF-15水平,并于氯吡格雷抗血小板治疗后,计算血小板聚集抑制率。采用多因素Logistic回归分析氯吡格雷抵抗的影响因素。结果 245例ACS患者中,氯吡格雷抵抗发生率为18.37%(45/245)。氯吡格雷抵抗患者的GDF-15水平高于氯吡格雷非抵抗患者[(1618.13±47.45)ng/L vs.(616.08±13.70)ng/L](P<0.05)。多因素Logistic回归分析结果显示,吸烟、糖尿病和LDL-C为ACS患者氯吡格雷抵抗的危险因素(P<0.05),而GDF-15为氯吡格雷抵抗的保护因素(P<0.05)。结论氯吡格雷抵抗患者的血清GDF-15水平显著升高,为ACS患者发生氯吡格雷抵抗的保护因素。

Objective To investigate the correlation between clopidogrel resistance and growth differentiation factor-15（GDF-15）in the patients with acute coronary syndrome（ACS）.Methods Serum level of GDF-15 was detected by ELISA method in 245 patients with ACS.The inhibition rate of platelet aggregation was calculated after treatment of clopidogrel antiplatelet.The factors influencing clopidogrel resistance were analyzed using multivariate Logistic regression analysis.Results The incidence of clopidogrel resistance in 245 patients with ACS was 18.37%（45/245）.Serum level of GDF-15 in the patients with clopidogrel resistance was higher than that in those without clopidogrel resistance[（1618.13±47.45）ng/L vs.（616.08±13.70）ng/L]（P〈0.05）.Multivariate Logistic regression analysis showed that smoking,diabetes and LDL-C were the risk factors for clopidogrel resistance（P〈0.05）,while GDF-15 was the protective factor for that in the patients with ACS（P〈0.05）.Conclusion Serum level of GDF-15 is significantly increased in the patients with clopidogrel resistance,which is a protective factor for clopidogrel resistance in the patients with ACS.