急性冠状动脉综合征患者阿司匹林抵抗的危险因素分析  

Risk factors of aspirin resistance in patients with acute coronary syndrome

作　　者：赵宏磊 白涛[1] 薛金熔[1] 刘永民[1] 孙立忠[1] Zhao Honglei;Bai Tao;Xue Jinrong;Liu Yongmin;Sun Lizhong(Department of Cardiac Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院心脏外科

出　　处：《中国医药》2019年第11期1614-1617,共4页China Medicine

基　　金：国家科技支撑计划(2015BAI12B03)~~

摘　　要：目的探讨急性冠状动脉综合征(ACS)患者发生阿司匹林抵抗(AR)的危险因素。方法选择首都医科大学附属北京安贞医院2015年10月至2018年10月收治的ACS患者341例,根据血小板功能检测结果,将患者分为阿司匹林敏感(AS)组(血小板聚集率≤20%)309例,AR组(血小板聚集率>20%)32例。比较2组患者的基线资料、用药情况和实验室指标(肌酐清除率、血尿酸、空腹血糖、三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和血小板计数)水平,分析AR的危险因素。结果341例ACS患者AR的发生率为9.4%(32/341)。AR组2型糖尿病史、吸烟史比例和空腹血糖水平均高于AS组[62.5%(20/32)比30.7%(95/309)、71.9%(23/32)比53.4%(165/309)、6.3(5.2,10.0)mmol/L比5.6(5.0,6.8)mmol/L],差异均有统计学意义(均P<0.05)。Logistic多因素回归分析结果显示,2型糖尿病史和吸烟史为发生AR的独立危险因素(回归系数=1.422、0.956,比值比=4.417、2.602,95%置信区间:1.924~9.941、1.142~5.930,P<0.001、P=0.023)。结论2型糖尿病史和吸烟史均为ACS患者发生AR的独立危险因素。Objective To explore the risk factors of aspirin resistance(AR)in patients with acute coronary syndrome(ACS).Methods Totally 341 patients with ACS were enrolled in Beijing Anzhen Hospital,Capital Medical University from October 2015 to October 2018.According to platelet function testing results,the patients were divided into aspirin sensitive(AS)group(platelet aggregation rate≤20%,309 cases)and AR group(platelet aggregation rate>20%,32 cases).Basic information,drug use,laboratory indicators(creatinine clearance rate,serum uric acid,fasting blood glucose,triglyceride,total cholesterol,high density lipoprotein cholesterol,low density lipoprotein cholesterol and platelet count)were recorded to analyze the risk factors of AR.Results Incidence of AR was 9.4%(32/341).In AR group there were more patients with type 2 diabetes history and smoking history and higher fasting blood glucose level as compared with AS group[62.5%(20/32)vs 30.7%(95/309),71.9%(23/32)vs 53.4%(165/309),6.3(5.2,10.0)mmol/L vs 5.6(5.0,6.8)mmol/L](all P<0.05).Multivariate logistic regression showed that type 2 diabetes history and smoking history were independent risk factors of AR(regression coefficient=1.422,0.956;odds ratio=4.417,2.602;95%confidence interval:1.924-9.941,1.142-5.930;P<0.001,P=0.023).Conclusion Type 2 diabetes history and smoking history are independent risk factors of AR in patients with ACS.

关 键 词：急性冠状动脉综合征 阿司匹林抵抗 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]