氯吡格雷抵抗对冠心病伴糖尿病患者冠脉介入预后的影响

Effect of Clopidogrel Resistance on Coronary Intervention Prognosis in Patients With Coronary Heart Disease and Diabetes Mellitus

目的探究氯吡格雷抵抗对冠心病伴糖尿病患者冠脉介入预后的影响。方法选取2016年1月—2017年1月我院接收的60例冠心病伴糖尿病患者冠脉介入患者,根据是否氯吡格雷抵抗分为两组,对照组25例(血小板抑制率超过50%,氯吡格雷抵抗);观察组35例(血小板抑制率低于50%,非氯吡格雷抵抗),两组均接受阿司匹林联合氯吡格雷治疗,比较两组介入治疗指标与预后情况。结果两组靶病变位置、植入支架数、支架总长度等介入指标组间差异无统计学意义(P>0.05)。观察组心肌梗死、院内不良预后1例,占2.86%,死亡0例,占0.00%,对照组心肌梗死、院内不良预后9例,占36.00%,死亡5例,占20.00%,组间差异具有统计学意义(P<0.05)。结论氯吡格雷抵抗对冠心病伴糖尿病患者冠脉介入预后的影响不利,需引起临床重视。

Objective To investigate the effect of clopidogrel resistance on the prognosis of coronary intervention in patients with coronary heart disease and diabetes mellitus. Methods From January 2016 to January 2017, 60 patients with coronary intervention in our hospital were divided into two groups according to clopidogrel resistance, 25 patients in control group （platelet inhibition rate over 50%, clopidogrel resistance）, 35 patients in observation group （platelet inhibition rate below 50%, non-clopidogrel resistance）. All patients were treated with aspirin plus clopidogrel, and the prognosis and prognosis were compared between the two groups. Results There were no signifcant diferences between the two groups in the target lesion location, the number of implants, and the total length of the stent （P 〉 0.05）. In the observation group, 1 case of myocardial infarction and poor prognosis in hospital, accounting for 2.86%, 0 cases of death, accounting for 0.00%. The control group had 9 cases of myocardial infarction and poor prognosis in hospital, accounting for 36.00%, and 5 cases died, accounting for 20.00%, the diference was statistically signifcant （P 〈 0.05）. Conclusion Clopidogrel resistance has adverse effects on the prognosis of coronary intervention in patients with coronary heart disease and diabetes mellitus, which should be paid attention to clinically.