吸烟和血小板分布宽度对冠心病患者氯吡格雷抵抗的影响  

Impact of smoking and platelet distribution width on clopidogrel resistance in patients with coronary artery disease

作　　者：刘艳红[1] 焦占全[2] 李彤[1] 刘迎午[1] 彭文近[1] 宁萌[1] LIU Yanhong;JIAO Zhanquan;LI Tong;LIU Yingwu;NING Meng

机构地区：[1]天津市第三中心医院心脏中心,天津市人工细胞重点实验室,卫生部人工细胞工程技术研究中心,300170 [2]天津医科大学第二医院心脏科,300211

出　　处：《实用医学杂志》2017年第14期2336-2340,共5页The Journal of Practical Medicine

摘　　要：目的探讨吸烟及血小板参数与冠心病患者氯吡格雷抵抗的关系。方法选取2015年5-12月收治的接受择期冠脉介入治疗的冠心病患者共216例,平均年龄63岁,男146例,女70例。依据血小板聚集试验结果分为氯吡格雷抵抗组(CR组)和氯吡格雷正常反应组(NCR组),比较两组的吸烟,饮酒,糖尿病等病史,基线用药情况,血小板计数,血小板分布宽度,平均血小板体积,糖化血红蛋白等参数,及冠脉造影和心脏超声检查结果。结果 CR组吸烟患者比例低于NCR组,差异有统计学意义(P<0.05);CR组患者用药前后血小板分布宽度变化值小于NCR组,差异有统计学意义(P<0.05)。结论吸烟可能是发生氯吡格雷抵抗的保护因素,应用氯吡格雷前后血小板分布宽度变化值可以反映氯吡格雷抵抗程度。Objective To explore the influence of smoking on clopidogrel resistance in patients with coronary artery disease.Methods A total of216patients with coronary artery disease who accept selective percutaneous coronary intervention in our hospital from May2015to December2015were selected as study subjects;their average age was63years old,146were male and70were female.All the patients were divided into clopidogrel resistance group(CR group)and normal clopidogrel response group(NCR group)according to the results of platelet aggregation test.History of smoking,alcohol drinking and diabetes mellitus,baseline medication uses,level of platelet counts,platelet distribution width,mean platelet volume,HbA1c,and results of echocardiogram and coronary angiography were compared between the two groups.Results The rate of smoking was significantly higher in CR group than in NCR group(P<0.05).The changed value of PDW before and after treatment with clopidogrel was smaller in CR group than in NCR group,the difference was statistically significant(P<0.05).Conclusions Smoking may be a protective factor for clopidogrel resistance.The changed value of PDW before and after treatment with clopidogrel can reflect the level of clopidogrel resistance.

关 键 词：冠心病 氯吡格雷抵抗 吸烟 血小板分布宽度 

分 类 号：R541.4[医药卫生—心血管疾病]