尿11-脱氢血栓素B2水平与2型糖尿病合并冠心病患者阿司匹林临床疗效的相关性研究.docVIP

· 920 · 920 · 北 京 大 学 学 报 ( 医 学 版 ) JOURNAL OF PEKING UNIVERSITY(HEALTH SCIENCES) Vol.47 No.6 Dec. 2015 · 论 著 · 尿11-脱氢血栓素 B2 水平与2型糖尿病合并 冠心病患者阿司匹林临床疗效的相关性研究 刘滕飞，张婧薇，陈夏欢，冯雪茹，柏中胜，刘梅林 (北京大学第一医院老年内科，北京 100034) [摘 要] 目的：检测尿中阿司匹林的代谢产物血小板血栓素(11-脱氢血栓素 B2,11-dehydrothromboxane B2, 11dhTxB2)水平，探讨其与2型糖尿病合并冠心病患者服用阿司匹林临床疗效的相关性。方法：本研究为前瞻性的队 列研究，入选169例北京大学第一医院老年内科2型糖尿病合并冠心病的住院患者。采用酶联免疫吸附试验(en- zyme-linked immuno-sorbent assay,ELISA)测定尿中阿司匹林代谢产物11dhTxB2的水平，阿司匹林低反应性，即阿司匹 林作用下的血小板高反应性(high on aspirin platelet reactivity,HAPR)定义为11dhTxB2≥1500 ng/g。根据检测结果 将入选患者分为HAPR 组和非血小板高反应性组(No-HAPR)。 籍果：2型糖尿病合并冠心病患者的基线尿11dhTxB2 水平为(3687±3052)ng/g,服用阿司匹林治疗后尿11dhTxB2水平显著降低[(1054±859)ng/g,P0.001];2 型糖 尿病合并冠心病患者中HAPR 的发生率为32.5%,且 HAPR 组心血管事件的发生率明显高于No-HAPR 组(P 0.05) 。结论：尿11dhTxB2水平可作为评价2型糖尿病合并冠心病患者阿司匹林临床疗效的有效预测指标。 [关键词]11-脱氢血栓素B2;血小板聚集；阿司匹林；冠心病；糖尿病，2型 [中图分类号]R541.4 [文献标志码] A [文章编号]1671-167X(2015)06-0920-05 doi:10.3969/j.issn.1671- 167X.2015.06.006 Correlation between the level of the urinary 11-dehydrothromboxane B2 and the clinical efficacy of aspirin in patients with type 2 diabete and coronary artery disease LIU Teng-fei, ZHANG Jing-wei, CHEN Xia-huan, FENG Xue-ru, BAI Zhong-sheng, LIU Mei-lin^ (Department of Geriatrics,Peking University First Hospital, Beijing 100034,China) ABSTRACT Objective: To elucidate the correlation between urinary 11-dehydro-thromboxane B2 (11dhTxB2)and clinical efficacy of aspirin treatment in patients with type 2 diabete and coronary artery disease(CAD). Methods: In this prospective cohort study, 169 aged patients with type 2 diabete accom- panying CAD in Peking University First Hospital were enrolled. The level of urinary 11dhTxB2 was detec- ted using enzyme-linked immuno-sorbent assay. Low aspirin response or high on aspirin platelet reactivity (HAPR)was defined as urinary 11dhTxB21500 ng/g. All the included patients were divided into two group