老年心血管病合并高同型半胱氨酸血症患者阿司匹林抵抗发生率及危险因素调查  

Aspirin resistance in elderly cardiovascular disease patients with hyperhomocysteinaemia and its risk factors

作　　者：陈德友[1] 刘霖[2] 邹晓[3] 曹剑[3] 孙玉发[4] 邓新立[5] 范利[3] 

机构地区：[1]解放军总医院门诊部干部诊疗科,北京100853 [2]解放军总医院南楼呼吸科,北京100853 [3]解放军总医院南楼心血管内科,北京100853 [4]解放军总医院总参警卫局卫生保健处,北京100853 [5]解放军总医院南楼检验科,北京100853

出　　处：《中华老年心脑血管病杂志》2015年第11期1140-1143,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：军队保健课题(12BJZ39);总参军事医学和老年病科研基金(ZCWS14B09);解放军总医院临床扶持基金(2012FCTSYS-2019)

摘　　要：目的探讨老年心血管病患者合并高同型半胱氨酸血症（Hhcy）的阿司匹林抵抗（AR）的发生率及危险因素。方法共纳入370例老年心血管病患者,其中Hhcy患者216例（Hhcy组）,非Hhcy患者154例（对照组）,均接受常规阿司匹林治疗（≥75mg）〉1个月。阿司匹林的疗效评价采用光比浊法检测血小板聚集率,AR定义为花生四烯酸诱导的血小板聚集率≥20%。结果 Hhcy组AR发生率显著高于对照组（16.7%vs 7.8%,P=0.012）;与对照组比较,Hhcy组同型半胱氨酸和肌酐水平显著升高（P〈0.05,P〈0.01）。logistic回归分析显示,Hhcy是发生AR的独立危险因素（OR=2.406,95%CI：1.201~4.820,P=0.013）。结论老年心血管病患者合并Hhcy的AR发生率明显增加,Hhcy是老年心血管病患者发生AR的重要危险因素。Objective To study the aspirin resistance（AR）in elderly cardiovascular disease（CVD）patients with hyperhomocysteinaemia（Hhcy）and its risk factors.Methods Three hundred and seventy elderly CVD patients were divided into Hhcy group（n=216）and control group（n=154）.The patients received conventional aspirin therapy（≥75mg）over 1month.The therapeutic effect of aspirin was assessed according to the platelet aggregation rate detected by light turbidimetry.AR was defined when the arachidonic acid-induced platelet aggregation rate was ≥20%.Results The prevalence of AR was significantly higher in Hhcy group than in control group（16.7%vs 7.8%,P=0.012）.The serum Hcy and creatinine levels were significantly higher in Hhcy group than in control group（P〈0.05,P〈0.01）.Hhcy was an independent risk factor for AR（OR=2.406,95%CI：1.201-4.820,P=0.013）.Conclusion The prevalence of AR is significantly higher in elderly CVD patients with Hhcy which is an important risk factor for AR.

关 键 词：心血管疾病 高同种半胱氨酸血症 阿司匹林 血小板聚集 

分 类 号：R54[医药卫生—心血管疾病] R589.7[医药卫生—内科学]