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1、老年冠心病患者阿司匹林抵抗的临床研究作者：李甜,党淑萍,III文华单位：陕西省科技厅社发攻关资助项目(NO.2007K13-03)陕西省人民医院老年心血管科，陕西西安【摘要】目的：探讨老年冠心病患者阿司匹林抵抗(AR)的发生率及英临床特征，评价AR的相关危险因素。方法:对135例患老年冠心病,口服阿司匹林≥100mg超过7d的患者,采用血小板聚集仪分别测立花生四烯酸、二磷酸腺甘(ADP)诱导的血小板聚集率(PAR)。AR的定义：用0.5mmol/L花生四烯酸诱导，平均PAR≥20%,用10μmol/L的ADP诱导，平均PAR≥70%0
2、阿司匹林半抵抗(ASR)即符合上述AR两条件之一者，均不满足者为阿司匹林敏感(AS)o用统计学方法分析各纽间各项临床特征差异及影响AR与ASR的独立危险因素。结果:AR、ASR及AS发生率分别为13.3%(⑻135)、28.9%(39/135)及57.8%(78/135)o与AS者和比，AR组中糖尿病患者明显增多，口该组患者纤维蛋白原(Fb)水平明显高于AS组[(4.21±1.09)g/LI(3.58±0.80)g/L,P<0.05]0Logistic回归分析表明,糖尿病[相对比值比(OR)=7.402,95%可信区间(CI
3、)3.110〜17.620,P<0.01]是发生AR与ASR的独立危险因素。结论：研究人群中阿司匹林抵抗的发生率为13.3%,发生AR与ASR可能与糖尿病有关，高Fb患者发生AR的危险性升高。【关键词】老年人;冠状动脉疾病;阿司匹林Morbidityrateandclinicalfeatureofaspirinresistanceanditsriskfactorsinelderlypatientswithcoronaryarterydisease/LIZhe,DANGShuping,TIANWenhua,WUXianhong//ChineseJourn
4、alofCardiovascularRehabilitationMedicine,2009,18(5):452Abstract：Objective:Tostudythemorbidityrateandclinicalfeatureofaspirinresitance(AR)anditsriskfactorsinelderlypatientswithcoronaryarterydisease(CAD).Methods:Atotalof135elderlyCADpatientstookaspirinlOOmg/dfor1week.Theplateletaggre
5、gationinducedfromadenosinediphosphate(ADP)andarachidonicacid(AA)wasusedtoevaluateAR.ARwasdefinedasastateinwhichaggregationof≥20%withAAandthat≥70%withADPwasfound.Aspirinsemiresistance(ASR)wasdefinedasmeetingoneoftheabovecriteria.Iftheabovecriteriawerenotmet,theconditionwasdefi
6、nedasaspirinsensitive(AS).ThedifferenceinclinicalcharacteristicsamongabovethreegroupsandindependentriskfactorsassociatedwithARandASRwereanalyzed.Results:The13.3%patientsshowedAR,28.9%showedASR,57.8%showedAS.AmongAR,thediabeticpatientswerepredominant.ThefibrinogenlevelofARwassignifi
7、cantlyhigherthanthatofASpatients[(4.21±l・09)g/Lvs.(3.58±0.80)g/L,P<0.05].LogisticregressionanalysisshowedthatdiabetesmellituswasanindependentriskfactorofARandASR(OR=7.402,95%CI3.110-17.620,P<0.01).Conclusion:Theaspirinresistanceaccountsfor13.3%ofelderlyCADpatien
8、ts.Thediabetesmellitusisre
