高同型半胱氨酸血症对老年糖尿病患者阿司匹林抵抗的影响  

Clinical study on aspirin resistance in elderly T2DM patients with hyperhomocysteinemia

作　　者：陈哲[1] 苗莉[1] 张鹏睿[1] 潘永华[1] 宁志伟[1] 王广[1] 徐援[1] 

机构地区：[1]首都医科大学附属北京朝阳医院内分泌科,北京100020

出　　处：《中国糖尿病杂志》2015年第11期1003-1006,共4页Chinese Journal of Diabetes

基　　金：首都临床特色基金(Z131107002213024);首都医科大学基础-临床科研合作基金(14JL14)

摘　　要：目的探讨高同型半胱氨酸血症(HHcy)和糖尿病对阿司匹林抵抗(AR)的影响。方法选取老年T2DM患者(T2DM组)50例和非糖尿病老年人(Con)组40例,另根据是否伴HHcy分为糖尿病合并HHcy亚组(H-DM)、单纯糖尿病亚组(NH-DM)、非糖尿病合并HHcy(H-Con)亚组及单纯非糖尿病(NH-Con)亚组,均口服阿司匹林1个月以上。通过血栓弹力图法评估血小板聚集功能。结果T2DM组Hcy高于Con组[(16.60±6.58)vs(13.18±4.33)μmol/L,P<0.05],而AR发生率增高(34.0%vs 10.0%,P<0.01)。H-DM亚组胰岛素抵抗指数(HOMA-IR)高于NH-DM亚组[(3.92±2.16)vs(2.72±1.50),P<0.05],AR发生率增高(44.0%vs 24.0%,P<0.01)。Hcy水平和AR呈负相关(r=-0.558,P<0.01)。结论伴有HHcy的老年T2DM患者AR发生率较高,其导致的IR可促进这一过程的进展。Objective To investigate the combined effect of HHcy and T2 DM on AR. MethodsAll the participants were divided into two groups：elderly T2 DM group（T2DM group,n=50）and elderly non-DM group（Control group,n=40）.All the subjects were also divided into four subgroups according to their HHcy level：T2DM patients with HHcy subgroup（H-DM subgroup,n=20）,T2 DM patients without HHcy subgroup（NH-DM subgroup,n=30）,non-DM patients with HHcy subgroup（H-Con subgroup,n=10）and non-DM patients without HHcy subgroup（NH-Con subgroup,n=30）.All patients were orally administered aspirin 100 mg daily over one month.Platelet aggregation was measured by thrombelastography（TEG）. Results Hcy level and AR incidence were both significantly higher in T2 DM group than in Con group[（16.60±6.58）vs（13.18±4.33）μmol/L,P〈0.05;34.0%vs 10.0%,P〈0.01].HOMA-IR and AR incidence were both significantly higher in H-DM subgroup than in NHDM subgroup[（3.92±2.16）vs（2.72±1.50）,P 0.05;44.0% vs 24.0%,P 0.01].AR was negatively correlated with Hcy level（r=-0.558,P〈0.01）. Conclusion AR incidence was high in elderly T2 DM patients.The high incidence of AR will result in IR,and the induced IR will aggravate AR in return.

关 键 词：老年 高同型半胱氨酸血症 糖尿病 阿司匹林抵抗 

分 类 号：R587.2[医药卫生—内分泌] R589[医药卫生—内科学]