血小板高反应性对冠心病合并糖尿病患者介入治疗术后不良事件的预测  

Value of high platelet reactivity in predicitng major adverse cardiovascular events in DM patients with CHD afttr PCI

作　　者：申文彬[1] 白静[1] 赵小慧[2] 杨霞[1] 孙婷[1] 赵宇[1] 刘庆艳[1] 王禹[1] 苏邵萍 

机构地区：[1]解放军总医院心内科,北京100853 [2]新乡市中心医院妇产科 [3]解放军总医院干部诊疗科,北京100853

出　　处：《中华老年心脑血管病杂志》2016年第4期391-393,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨血小板高反应性对冠心病合并糖尿病患者行PCI术后发生临床终点事件的预测价值。方法回顾性分析行PCI的患者263例,平均随访（362.6±66.7）d。根据是否诊断为糖尿病,分为糖尿病组61例和非糖尿病组202例。二磷酸腺苷（ADP）诱导的血小板高反应性（HPR）定义为血小板聚集率≥50%。结果糖尿病组患者ADP诱导的HPR比例显著高于非糖尿病组（27.9%vs 16.3%,P=0.044）。糖尿病组HPR患者PCI术后主要不良心血管事件（MACE）发生率显著高于非HPR患者（35.3%vs 6.8%,P=0.016）,HPR与PCI术后发生MACE的相关系数在糖尿病组与非糖尿病组中分别为0.361（P=0.01,95%CI：1.6~64.7）、0.277（P=0.209,95%CI：0.6~7.5）。结论 HPR与MACE的关系在糖尿病组要强于非糖尿病组。Objective To study the value of high platelet reactivity（HPR）in predicitng the major adverse cardiovascular events（MACE）in DM patients with CHD following PCI.Methods Clinical data of 263 patients following PCI were retrospectively analyzed.The patients were followed up for 362.6±66.7days and divided into DM group（n=61）and non-DM group（n=202）.ADPinduced HPR was defined as platelet aggregation rate ≥50%.Results The ADP-induced HPR was significantly higher in DM group than in non-DM group（27.9%vs 16.3%,P=0.044）.The incidence of MACE was significantly higher in DM patients with HPR than in those without HPR following PCI（35.3%vs 6.8%,P=0.016）.The correlation coefficient of HPR and MACE following PCI was 0.361（P=0.01,95%CI：1.6-64.7）and 0.277（P=0.209,95%CI：0.6-7.5）respectively in DM group and non-DM group.Conclusion The association between HPR and MACE is closer in DM group than in non-DM group.

关 键 词：血小板增多 冠心病 糖尿病 血小板聚集 血小板聚集抑制剂 血栓弹力描记术 

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