尿11-脱氢血栓素B2水平与2型糖尿病合并冠心病患者阿司匹林临床疗效的相关性研究  

Correlation between the level of the urinary 11-dehydrothromboxane B2 and the clinical efficacy of aspirin in patients with type 2 diabete and coronary artery disease

作　　者：刘滕飞[1] 张婧薇 陈夏欢[1] 冯雪茹[1] 柏中胜 刘梅林[1] 

机构地区：[1]北京大学第一医院老年内科,北京100034

出　　处：《北京大学学报（医学版）》2015年第6期920-924,共5页Journal of Peking University:Health Sciences

基　　金：国家国际科技合作专项项目(2013DFA30860)资助~~

摘　　要：目的:检测尿中阿司匹林的代谢产物血小板血栓素(11-脱氢血栓素B2,11-dehydrothromboxane B2,11dh Tx B2)水平,探讨其与2型糖尿病合并冠心病患者服用阿司匹林临床疗效的相关性。方法:本研究为前瞻性的队列研究,入选169例北京大学第一医院老年内科2型糖尿病合并冠心病的住院患者。采用酶联免疫吸附试验(enzyme-linked immuno-sorbent assay,ELISA)测定尿中阿司匹林代谢产物11dh Tx B2的水平,阿司匹林低反应性,即阿司匹林作用下的血小板高反应性(high on aspirin platelet reactivity,HAPR)定义为11dh Tx B2≥1 500 ng/g。根据检测结果将入选患者分为HAPR组和非血小板高反应性组(No-HAPR)。结果:2型糖尿病合并冠心病患者的基线尿11dh Tx B2水平为(3 687±3 052)ng/g,服用阿司匹林治疗后尿11dh Tx B2水平显著降低[(1 054±859)ng/g,P<0.001];2型糖尿病合并冠心病患者中HAPR的发生率为32.5%,且HAPR组心血管事件的发生率明显高于No-HAPR组(P<0.05)。结论:尿11dh Tx B2水平可作为评价2型糖尿病合并冠心病患者阿司匹林临床疗效的有效预测指标。Objective： To elucidate the correlation between urinary 11-dehydro-thromboxane B2（ 11 dh Tx B2） and clinical efficacy of aspirin treatment in patients with type 2 diabete and coronary artery disease（ CAD）. Methods： In this prospective cohort study,169 aged patients with type 2 diabete accompanying CAD in Peking University First Hospital were enrolled. The level of urinary 11 dh Tx B2 was detected using enzyme-linked immuno-sorbent assay. Low aspirin response or high on aspirin platelet reactivity（ HAPR） was defined as urinary 11 dh Tx B2 1 500 ng /g. All the included patients were divided into two groups based on the results,HAPR group and No-HAPR group. Results： Baseline urinary 11 dh Tx B2 of the patients with type 2 diabete accompanying CAD was（ 3 687 ± 3 052） ng / g,while the urinary11 dh Tx B2 was（ 1 954 ± 859） ng / g in patients after 100 mg / d aspirin treatment（ P〈0. 001）. Prevalence of HAPR in patients with type 2 diabete accompanying CAD were 32. 5%. Within a mean follow-up time of 12 months,the outcomes occurred more frequently in HAPR group than in No-HAPR group（ P〈0. 05）. Conclusion： Urinary 11 dh Tx B2 can be recognized as an effective indicator in evaluating aspirin clinical efficacy of patients with type 2 diabete accompanying CAD.

关 键 词：11-脱氢血栓素B2 血小板聚集 阿司匹林 冠心病 糖尿病 2型 

分 类 号：R541.4[医药卫生—心血管疾病]