冠心病合并糖尿病患者经皮冠状动脉介入治疗后氯吡格雷低反应的发生率及危险因素.docVIP

冠心病合并糖尿病患者经皮冠状动脉介入治疗后氯吡格雷低反应的发生率及危险因素 　　[摘要] 目的 评价择期经皮冠状动脉介入治疗的冠心病合并2型糖尿病患者中氯吡格雷低反应的发生率及危险因素。 方法 采用回顾性病例对照研究，选取2015年1～9月于首都医科大学附属北京安贞医院行经皮冠状动脉介入治疗的冠心病合并2型糖尿病患者210例，所有患者均于术前至少6 h给予负荷量的氯吡格雷300 mg，分别于服药前及服药至少24 h后取血，光学比浊法测定二磷酸腺苷（ADP）诱导的血小板聚集率。服药前血小板聚集率与服药后血小板聚集率绝对差值≤10%定义为氯吡格雷低反应，据此将患者分为正常组（n=133）和低反应组（n=77），计算氯吡格雷低反应的发生率，并分析年龄、性别、吸烟、血压、血脂、糖化血红蛋白等指标与氯吡格雷低反应的相关性。 结果 经皮冠状动脉介入术后的冠心病合并2型糖尿病患者中氯吡格雷低反应的发生率为36.67%。低反应组和正常组ADP诱导的血小板聚集率在基线水平差异无统计学意义（P 0.05），在服药24 h后测定分别为（62.62±9.23）%与（32.71±11.77）%，两组间差异有高度统计学意义（P 中国论文网 /6/view-7215439.htm 　　[关键词] 经皮冠状动脉介入；氯吡格雷低反应；糖化血红蛋白；糖尿病 　　[中图分类号] R541 [文献标识码] A [文章编号] 1673-7210（2016）01（c）-0013-04 　　Incidence of low response of Clopidogrel and its risk factors in patients with coronary heart disease and type 2 diabetes treated with percutaneous coronary intervention 　　ZHAI Guangyao ZHOU Yujie▲ 　　12 Ward of Department of Cardiology， Beijing Anzhen Hospital， Capital Medical University， Beijing 100029， China 　　[Abstract] Objective To assess the incidence of low response of Clopidogrel and its risk factors in patients with coronary heart disease and type 2 diabetes treated with percutaneous coronary intervention （PCI）. Methods A retrospective case-control study was adopted in this study. 210 patients with coronary heart disease and type 2 diabetes who underwent selective PCI in Beijing Anzhen Hospital Affiliated to Capital Medical University from January to September 2015 were selected. All patients received a loading dose of Clopidogrel 300 mg at least 6 h before PCI. All the patients were taken blood samples before Clopidogrel administration as the baseline and at least 24 h post-medication. ADP induced platelet aggregation was measured by light transmittance aggregometry. Low response of Clopidogrel was defined as the absolute difference of the platelet between baseline and post-medication ≤10%. The patients were divided into the normal group （n=133） and the low-response group （n=77）， the incidence of low response of Clopidogrel was ca