冠心病患者阿司匹林抵抗及其影响因素

被引：5

作者：

杨鲲

刘文娴

马琛明

吕树铮

机构：

[1] 首都医科大学附属北京安贞医院心内科监护室

来源：

中国介入心脏病学杂志 | 2009年 / 17卷 / 04期

关键词：

冠状动脉疾病; 血小板聚集; 阿司匹林抵抗;

D O I：

暂无

中图分类号：

R541.4 [冠状动脉（粥样）硬化性心脏病（冠心病）];

学科分类号：

摘要：

目的探讨冠心病患者阿司匹林抵抗(Aspirin resistance,AR)现象及其影响因素。方法入选1 731例入院诊断为冠心病(急性冠状动脉综合征和稳定型心绞痛)的患者。采用血小板聚集仪分别测定花生四烯酸(AA)、腺苷二磷酸(二磷酸腺苷,ADP)诱导的血小板聚集率。AR定义为0.5 mmol/L花生四烯酸时血小板平均聚集率≥20%,用10μmol/L ADP时血小板平均聚集率≥70%。阿司匹林半抵抗(Aspirin semiresistance,ASR)即符合上述两个条件之一者。均不符合者为阿司匹林敏感(Aspirin sensitive,AS)。用统计学方法分析各组间各项临床特征差异及影响AR与ASR的危险因素。结果1 731例患者中AR的发生率3.58%(62/1 731),ASR的发生率20.34%(352/1 731)。与AS相比,AR+ASR中以女性、高龄、高脂血症患者较多,吸烟者较少。而且AS患者的血小板计数偏高,总胆固醇水平偏低。Logistic回归分析表明,女性[相对比值比(OR)=1.377,95%可信区间(CI)1.084～1.751,P=0.009〗、老年(OR=1.504,95%CI1.005～2.253,P=0.047)、总胆固醇(TCHO)(OR=1.249,95%CI1.114～1.401,P=0.000)升高是发生AR与ASR的危险因素。结论服用阿司匹林的冠心病患者中AR发生率为3.58%,ASR发生率为20.34%。发生AR与ASR危险因素有女性、高龄、高血脂。

引用

页码：203 / 207

页数：5

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