高龄稳定性冠心病患者阿司匹林抵抗发生率及的影响因素分析.docVIP

高龄稳定性冠心病患者阿司匹林抵抗发生率及的影响因素分析 　　【摘要】 目的：研究高龄稳定性冠心病患者阿司匹林抵抗发生率，并分析阿司匹林抵抗发生的影响因素。方法：选取2012年1月-2013年6月笔者所在医院收治的239例高龄稳定性冠心病患者，采用血栓弹力图（thrombelastography，TEG）测定花生四烯酸（arachidonic acid，AA）诱导的血小板抑制率，根据结果分为阿司匹林抵抗（AR）组和阿司匹林敏感（AS）组；检测血生化、空腹血糖、氨基末端脑钠肽前体（amino-terminal pro-brain natriuretic peptide，NT-proBNP）、糖化血红蛋白（HbA1c）、胱抑素C等指标。结果：高龄合并冠心病患者AR的发生率为38.50%，与AS组比较，AR组肌酐、胱抑素C、NT-proBNP、空腹血糖、HbA1c水平均升高，比较差异均有统计学意义（P0.05）。Logistic回归分析显示，胱抑素C、HbA1c是AR发生的独立危险因素。结论：高龄稳定性冠心病患者AR发生率高，肾功能不全及血糖控制不良可能是AR发生的主要影响因素。 　　【关键词】 高龄； 稳定性冠心病； 阿司匹林抵抗； 血栓弹力图； 危险因素 　　doi：10.14033/j.cnki.cfmr.2017.35.023 文献标识码 B 文章编号 1674-6805（2017）35-0047-03 　　【Abstract】 Objective：To study the prevalence of aspirin resistance in elderly patients with the stable coronary artery disease and to analyze the influencing factors of aspirin resistance.Method：From January 2012 to June 2013，a total of 239 elderly patients with stable coronary artery disease admitted in our hospital were enrolled.According to the platelet inhibition rate of arachidonic acid（AA） by using thrombelastograph，patients were divided into two groups，aspirin-resistant group and aspirin-sensitivity group.The blood biochemical，glucose，NT-proBNP，HbA1c，cystatin C were measured.Result：The incidence of AR in elderly patients with coronary heart disease was 38.50%.Creatinine，cystatin C，NT-proBNP，fasting blood glucose，HbA1c levels in AR group were significantly higher than those in AS group，the differences were statistically significant（P0.05）.Logistic regression analysis suggested that HbA1c and cystatin C levels were independent risk factors for AR.Conclusion：The prevalence of aspirin resistance in elderly patients with the stable coronary artery disease is high.Renal insufficiency and higher blood glucose are risk factors for aspirin resistance. 　　【Key words】 Advanced age； Stable coronary artery disease； Aspirin resistance； Thrombelastograph； Risk factors 　　First-author’s address：Fujian Provincial Geriatric Hospital，Fuzhou 350003，China 　　?S着我国人口老龄化趋势，8