合并2型糖尿病的急性冠脉综合征患者PCI术后氯吡格雷抵抗危险因素分析  

Analysis of clopidogrel resistance in patients with type 2 diabetes mellitus complicated with acute coronary syndrome after percutaneous coronary intervention

作　　者：刘奕[1] 陈震[1] 冯春光[1] 娄明[1] 邵博一[1] 

机构地区：[1]江苏省徐州市中心医院心血管内科,221009

出　　处：《中国现代医药杂志》2015年第9期32-34,共3页Modern Medicine Journal of China

摘　　要：目的探讨合并2型糖尿病(DM)的急性冠脉综合征(ACS)患者经皮冠状动脉介入术(PCI)后发生氯吡格雷抵抗的情况,分析相关危险因素。方法 84例因ACS入院行PCI的患者,分为糖尿病组42例,非糖尿病组42例,根据血栓弹力图(TEG)监测血小板抑制率情况,比较两组临床资料,分析糖尿病患者氯吡格雷抵抗的相关危险因素。结果糖尿病组发生氯吡格雷抵抗11例(26.19%),非糖尿病组发生1例(2.38%),差异有统计学意义(P<0.05);糖尿病组空腹血糖水平、糖化血红蛋白(Hb A1c)水平、甘油三酯、超敏C反应蛋白水平(hs-CRP)均明显高于非糖尿病组(P<0.05);分析显示空腹血糖、糖化血红蛋白、超敏C反应蛋白是影响患者发生氯吡格雷抵抗的危险因素。结论合并2型糖尿病的ACS患者氯吡格雷抵抗发生率高,且与患者的空腹血糖水平、糖化血红蛋白水平、超敏C反应蛋白水平密切相关。Objective To discuss the clopidogrel resistance in patients with type 2 diabetes mellitus complicated with acute coronary syndrome（ACS） after percutaneous coronary intervention（PCI）. Methods The patients with ACS （n=84） re-ceived PCI were randomly divided into diabetic group and non-diabetic group （42 cases in each group）. The platelet aggrega-tion rate was compared by using Thrombelastography（TEG） between 2 groups after treatment with clopidogrel. The basic clini-cal data,related routine examination results were also compared between 2 groups. Independent risk factors of clopidogrel resis-tance were explored by multiple factor analysis. Results 11 patients （26.19%） had clopidogrel resistance in diabetic group, and 1 patient （2.38%） had clopidogrel resistance in non-diabetic group, the difference was statistically significant （P〈0.05）. While the fasting blood glucose,HbA1c lever,triglyceride and high sensitive C reactive protein in diabetic group were significant higher than those in non-diabetic group （P〈0.05）. The fasting blood glucose,HbA1c lever and high sensitive C reactive protein were risk factors of clopidogrel resistance in patients. Conclusion Type 2 diabetic patients with ACS undergoing PCI have a higher clopidogrel resistance rate than those non-diabetic patients, and that relevant factors are the fasting blood glucose,HbA1c lever and high sensitive C reactive protein.

关 键 词：急性冠脉综合征 2型糖尿病 氯吡格雷抵抗 

分 类 号：R541.4[医药卫生—心血管疾病] R587.1[医药卫生—内科学]