【摘要】 目的 探讨冠心病稳定型心绞痛患者阿司匹林抵抗(AR)的发生率,并分析该类患者的临床特征,便于临床上早期发现AR,改善该类患者的治疗现状。方法 选择内蒙古自治区人民医院心内科2011年1月至2012年5月住院冠心病患者200例,所有患者于每日早饭后顿服拜阿司匹林片100 mg,连续服用10 d后抽取肘静脉血,分别用花生四烯酸和二磷酸腺苷为诱导剂诱导血小板聚集,根据患者对阿司匹林的反应情况将患者分为AR+阿司匹林半抵抗组(50例),其中AR组(10例)、阿司匹林半抵抗组(40例),阿司匹林敏感组(150例),同时送检生化全项,对各项临床特征的组间差异进行对比分析。结果 AR组、阿司匹林半抵抗组、AR+阿司匹林半抵抗组、阿司匹林敏感组的AR发生率分别为5%(10/200)、20%(40/200)、25%(50/200)、75%(150/200)。AR+阿司匹林半抵抗组合并糖尿病例数、WBC、TC、TG、LDL-C、BMI等指标[16例、(5.4±2.0)×10~9/L、(5.5±1.6)mmol/L、(3.0±0.5)mmol/L、(3.0±1.4)mmol/L、(25.3±1.9)kg/m~2]与阿司匹林敏感组[12例、(4.6±0.6)×10~9/L、(4.7±1.0)mmol/L、(2.0±1.4)mmol/L、(2.6±0.9)mmol/L、(24.0±2.0)kg/m~2]比较,差异均有统计学意义(P<0.05或P<0.01)。结论 AR现象可能与血糖、血脂、体重指数、白细胞计数增高等因素有关,在这些状态下应警惕AR的发生,必要时增加剂量或应用其他药物替代治疗。更多还原

【Abstract】 Objective To discuss the occurrence rate of aspirin resistance(AR) in patients with stable angina pectoris of coronary heart disease;to evaluate the clinical characteristics of them;to facilitate early detection of clinical AR and improve the present status of treatment.Methods Totally 200 paients with coronary heart disease in the department of cardiology in the People’s Hospital of Inner Mongolia Autonomous Region from January 2011 to May 2012 were selected.All patients were given aspirin(100 mg/d for 10 days) after breakfast,and then the blood samples were collected for determination of optical platelet aggregation index using arachidonic acid(AA) and adenosine diphosphate(ADP).All patients were divided into AR + aspirin serai-resistance group(50 cases),aspirin resistance(AR) group(10 cases),aspirin semi-resistance group(40 cases) and aspirin sensitive group(150 cases) according to the antiplatelet effect of aspirin.The differences in clinical characteristics among the groups and associated factors were analyzed.Results Aspirin resistance occurrence rate of AR group,AR + aspirin semi-resistance group,aspirinsemi-resistance group and aspirin sensitive group was 5%(10/200),20%(40/200),25%(50/200) and 75%(150/200).There were significant differences on the number of cases with diabetes mellitus, white blood cell(WBC),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C), body mass index(BMI) between AR + aspirin emi-resistance group and aspirin sensitive group[AR + aspirin semiresistance group:16 cases,(5.4±2.0)×10~9/L,(5.5±1.6)mmol/L,(3.0±0.5)mmol/L,(3.0±1.4)mmol/L,(25.3±1.9) kg/m~2;aspirin sensitive group:12 cases,(4.6±0.6) × 10~9/L,(4.7±1.0) mmol/L,(2.0± 1.4)mmol/L,(2.6±0.9)mmol/L,(24.0+2.0)kg/m~2](P <0.05 or P <0.01).Conclusion Aspirin resistance is likely correlated with some clinical such as diabetes mellitus,hyperlipodemia,BMI and WBC.更多还原