摘要
目的:探讨冠心病患者冠状动脉介入治疗术(PCI)后氯吡格雷抵抗的影响因素。方法:159例行PCI术治疗的冠心病患者,术前予氯吡格雷300 mg负荷剂量治疗,术后予75 mg/d持续治疗。测其服药前、术后24 h和术后5 d以5μmol/L的二磷酸腺苷诱导的血小板最大聚集率。以血小板聚集抑制率≤10%定义为氯吡格雷抵抗,分为氯吡格雷抵抗组(抵抗组,n=48)和对氯吡格雷反应正常组(正常组,n=111),比较两组临床基本资料、相关常规检查、手术资料,Logistic回归分析氯吡格雷抵抗的独立危险因素。结果:159例患者中发生氯吡格雷抵抗48例,氯吡格雷抵抗发生率为30.2%。两组患者吸烟比例、并发糖尿病、三酰甘油水平的差异均有统计学意义(均P<0.05),两组患者手术资料各项参数比较差异无统计学意义。Logistic回归分析结果显示氯吡格雷抵抗的独立危险因素有糖尿病、长期吸烟。三酰甘油水平无统计学意义。结论:糖尿病、长期吸烟是冠心病患者PCI术后发生氯吡格雷抵抗的独立危险因素。
AIM：To explore the influential factors of clopidogrel resistance in patients with coronary heart disease （CHD） who received percutaneous coronary interventions （PCI）. METHODS： A total of 159 patients with CHD who underwent PCI were enrolled. Clopidogrel of 300 mg loading dose and 75 mg/day ongoing dose was administered before and after PCI. The 5 μmol/L adenosine diphosphate （ADP）induced maximum platelet aggregation rate （MPAR） was tested before administration as well as 24 h and 5 days after PCI. Patients were divided into clopidogrelresistant group （platelet aggregation rate ≤10%） and normal response group. Basic clinical data, related routine examination results, MARP and PCI characteristics were compared between groups and the independent risk factors of clopidogrel resistance were explored by logistic regression analysis. RESULTS： The incidence of clopidogrel resistance after PCI was 30% （40/159） in the 159 patients under study. Significant differences were found in patients with a long history of smoking, history of diabetes and triglyceride levels between groups （P〈0.05）, whereas no significant difference was observed in the PCI characteristics between groups. Logistic regression analysis revealed that history of diabetes and long history of smoking were independent risk factors of clopidogrel resistance but PCI characteristics were not related to clopidogrel resistance. CONCLUSION： Diabetes and long history of smoking may be risk factors for clopidogrel resistance in patients with CHD after PCI.
出处
《心脏杂志》
CAS
2013年第6期661-664,共4页
Chinese Heart Journal
基金
南京军区科技人才培养工程重点项目资助(12RC04)
南京军区福州总医院2012年基金资助项目(Y201203)
关键词
冠状动脉疾病
血小板聚集率
氯吡格雷抵抗
冠状动脉介入治疗术
coronary disease
platelet aggregation rate
clopidogrel resistance
percutaneous coronary intervention
