摘要
目的:了解糖尿病(DM)对急性心肌梗死(AMI)患者PCI术后血小板对氯吡格雷反应性的影响。方法:选择我院住院的AMI患者80例,其中急性ST段抬高型心肌梗死35例,非ST段抬高型心肌梗死45例。入院后均给予标准双联抗血小板治疗,7天后应用血栓弹力图仪测定二磷酸腺苷(ADP)诱导的血小板抑制率,抑制率低于20%定义为氯吡格雷反应不良,20%～50%为反应低下,大于50%为反应良好。根据是否合并DM,将患者分为DM组和非DM组,比较两组患者ADP诱导的血小板抑制率的差异。结果:80例AMI患者中合并DM患者28例,非DM患者52例,前者ADP诱导的血小板抑制率为(40.5±14.2)%,后者(61.7±21.6)%,两者差异用统计学意义(P<0.05)。合并DM的患者氯吡格雷反应不良比例高于非DM患者(28.6%v 19.2%),两组具有明显统计学差异(P<0.05)。结论:DM降低AMI患者血小板对氯吡格雷的反应性。
Objective： To understand the effect of diabetes mellitus（DM） on platelet response to clopidogrel in patients with acute myocardial infarction（AMI） after percutaneous coronary intervention（PCI）.Methods： 80 patients with AMI were recruited,including 35 STEMI patients and 45 NSTEMI patients.The standard anti-platelet therapy,immediately 300mg aspirin and 600mg clopidogrel followed by 100mg aspirin and 75mg clopidogrel per day was offered after admission.Platelet inhibition rate induced by adenosine diphosphate（ADP） was tested by thrombelastogram after admission 7 days.Lower inhibition rate than 20% was defined as adverse platelet response to clopidogrel.Inhibition rate 20%~50% is low.Inhibition rate more than 50% is good.The patients were divided into diabetes group and non-diabetes group based on diabetes history.The adenosine diphosphate（ADP）-induced platelet inhibition rate was compared between two groups.Results： There were 28 patients in diabetes group and 52 patients in non-diabetes group.The ADP-induced platelet inhibition rate was respectively（40.5±14.2）% and（61.7±21.6）% in diabetic group and non-diabetic group.There was obviously difference between two groups（P＆lt;0.05）.The proportion of lower response to clopidogrel in patients with DM is larger than that of nondiabetic patients（28.6% v 19.2%）,there was distinct significant change in two groups（P＆lt;0.05）.Conclusion： DM reduces the response of platelet to clopidogrel in patients with AMI after PCI.
出处
《中国医药导刊》
2013年第7期1128-1129,1131,共3页
Chinese Journal of Medicinal Guide
关键词
急性心肌梗死
糖尿病
血栓弹力图
血小板反应性
Acute myocardial infarction
Diabetes mellitus
Thrombelastogram
Platelet response
