应用血栓弹力图分析血糖控制与阿司匹林抵抗的关系  

Analysis of the relationship between glycemic control and aspirin resistance using TEG

作　　者：蔡婷婷[1] 王洁 张利[1] 范海波[1] 施建丰[1] 姚孝明[1] 杨婉薇[1] CAI Tingting;WANG Jie;ZHANG Li;IVAN Haibo;SHI Jianfeng;YAO Xiaorning;YA NG Wanwei(Department of Clinical laboratory,Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,J iangsu Province Academy of Traditional Chinese Medicine,Nanjing,J iangsu 210028,China;Department of Clinical Laboratory,Changzhou Children＇s Hospital,Changzhou,J iangsu 213003,China)

机构地区：[1]南京中医药大学附属中西医结合医院/江苏省中医药研究院检验科,南京210028 [2]常州市儿童医院检验科,江苏常州213003

出　　处：《国际检验医学杂志》2018年第20期2548-2550,共3页International Journal of Laboratory Medicine

摘　　要：目的应用血栓弹力图探讨血糖和血脂控制情况与阿司匹林抵抗(AR)的关系。方法选取2013年11月至2016年7月就诊于南京中医药大学附属中西医结合医院心内科患者99例,年龄≥40岁,单一服用阿司匹林(100mg/d)作为抗血小板药物,服药时间在1年以上。用血栓弹力图检测并计算阿司匹林对血小板的抑制率,以抑制率<50%记为阿司匹林抵抗(AR),同时检测患者血清空腹血糖、三酰甘油(TG)和总胆固醇(TC)水平,进而分析代谢状态与AR的关系。结果 99例病例的AR总体发生率为28.3%。根据空腹血糖结果将入组患者分为血糖正常组、糖耐量异常组和糖尿病组,3组患者血小板抑制率分别为(91.6±34.8)%、(64.0±81.9)%和(70.3±63.3)%,差异有统计学意义(P<0.05);根据血清TG结果将患者分为TG正常组(≤1.7mmol/L)和TG异常组(>1.7mmol/L),两组的血小板抑制率[(82.9±53.9)%vs.(78.0±62.9)%]和AR发生率(27.3%vs.30.3%)比较,差异均无统计学意义(P>0.05);根据血清TC结果将患者分为TC正常组(≤5.17mmol/L)和TC异常组(>5.17mmol/L),两组的血小板抑制率[(82.7±56.3)%vs.(83.3±77.4)%]和AR发生率(28.0%vs.29.4%)比较,差异均无统计学意义(P>0.05)。结论高血糖状态可能是干扰阿司匹林抑制血小板聚集的原因之一,AR的发生与有血糖控制有关。Objective To investigate the relationship between glycemic control and aspirin resistance by using thrombelastography. Methods Totally 99 patients over 40 years old who took aspirin as a long term antiplatelet therapy （≥1 year, 100 %ng/d） and were treated in Department of Cardiology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine were enrolled into the study. The inhibition rate of aspirin on platelet was measured and calculated by thro%abelastography and the inhibition rate less than 50% was considered as aspirin resistance. Meanwhile, the fasting blood glucose,triglyceride （TG） and total cholesterol （TC） levels were detected,and then the relationship between metabolic status and AR were analyzed. Results Among the 99 patients enrolled in the study,28.3% were as pirin-resistance. According to the fasting glucose levels, patients were divided into three groups; normal glu cose group, impaired glucose tolerance group and diabetes group. The aspirin-caused platelet inhibition rates of the three groups were （91.6±34.8）%、（64.0±81.9）%and（70.3±63.3） % respectively,which showed significant differences （P〈O. 05）. According to the serum TG levels,patients were divided into normal TG group （%1.2 retool/L） and hypertriglyceriden%ia TG group （≤1.7mmol/L）. There were no statistically sig nificant difference between the two groups referring to the aspirin caused platelet inhibition ratio %（82.9±53.9）% vs. （78.0±62.9）% and the incidence rate of AR （22.3% vs. 30.35%）. According to the serun% total cholesterol levels,the patients were divided into nor%al TC group （≤5.17mmol/L） and hypercholesteremia （TC） group （〉5.12mmol/L）. There were no significant difference between the two groups referring to aspitin caused platelet inhibition ratio [（82.7±56.3）%vs.（83.3±77.4）%] and the incidence rate of AR （28.0%vs.29.4%）.Conclusion Hyperglycemia may be one of the factors causing

关 键 词：阿司匹林抵抗 血小板抑制率 血糖控制 血栓弹力图 

分 类 号：R587.1[医药卫生—内分泌]