腰臀比对心肌梗死患者介入术后血小板聚集率的影响  

The influence of waist- hip ratio on platelet aggregation rate in myocardial infarction patients after implantation

作　　者：吕娜娜[1] 张宁[2] 郭蕾[2] 宋梅[2] 张振伟[1] 宋继萍[1] 陈芳[2] 

机构地区：[1]宁夏医科大学,宁夏银川750004 [2]宁夏银川市第一人民医院心内科,宁夏银川750001

出　　处：《宁夏医学杂志》2015年第1期10-13,共4页Ningxia Medical Journal

基　　金：宁夏科技攻关计划项目(2012ZYS212)

摘　　要：目的了解腰臀比(WHR)对ST段抬高性心肌梗死(STEMI)患者经皮冠状动脉介入术(PCI)后血小板聚集率的影响。方法选取141例STEMI后行择期PCI的中老年患者测量腰围、臀围,按WHR分为正常组、轻度中心性肥胖组、重度中心性肥胖组,术后第2天晨用比浊法测ADP诱导的血小板聚集率,对各组间的血小板聚集率进行比较。结果随着WHR的增大,患者的血小板聚集率呈现增高趋势(P<0.05)。偏相关分析显示,WHR与血小板聚集率间有相关性(r=0.333,P<0.05)。对应因子分析显示,男性WHR≥1.00、女性WHR≥0.95对应于血小板聚集率>50%,即氯吡格雷抵抗。结论 WHR与服氯吡格雷后的STEMI患者的血小板聚集率有正相关关系,对于男性WHR≥1.00、女性WHR≥0.95的患者,应考虑增加氯吡格雷用量,以抑制过高的血小板功能。Objective To evaluate the effect that WHR on the platelet aggregation rate in ST segment elevation myocardial in？farction （ STEMI） patients after percutaneous coronary artery stent implantation. Methods 141 patients were chosen after stent implan？tation. According to their waist circumference,hip circumference,waist- hip ratio,all this patients were administrated to normal group, mild central obesity group and severely central obesity group. The platelet aggregation rate induced by ADP was analyzed by turbidimetry in postoperative morning. The platelet aggregation rate of the three groups was compared. Results The rate of platelet aggregation in pa？tients increased with the increasing waist- hip ratio （P〈0. 05）. Partial correlation analysis showed that there was a correlation between waist- hip ratio and platelet aggregation rate （correlation coefficient 0. 333,P〈0. 05）. Correspondence factor analysis showed that male WHR≥1, female WHR≥0. 95 corresponded to the platelet aggregation rate more than fifly percent,i. e. clopidogrel resistance.Conclusion Waist- hip ratio is positive correlation with platelet aggregation rate of STEMI patients who have taken clopidogrel. When WHR ≥1 in male patients and WHR≥0. 95 female patients,it should be considered increasing the dosage of clopidogrel to inhibit the excessive platelet function.

关 键 词：腰臀比 中心性肥胖 血小板聚集率 急性心肌梗死 氯吡格雷抵抗 

分 类 号：R542.22[医药卫生—心血管疾病]