摘要
目的分析2型糖尿病合并脑梗死患者发生氯吡格雷抵抗的临床危险因素。方法选取2019年3月-2021年2月和平县人民医院收治的60例2型糖尿病合并脑梗死患者作为研究对象。将入选的60例患者根据血小板聚集率进行分组,将发生氯吡格雷抵抗的患者纳入研究组,未出现氯吡格雷抵抗的患者纳入对照组,两组各有30例患者。对比两组患者的流行病学指标、血脂相关指标、血糖相关指标、超敏C反应蛋白以及NIHSS评分、ASPECT评分。结果两组患者的流行病学指标(年龄、性别、吸烟史、喝酒史、高血压、冠心病)、TC、LDL-C、TG、HbA1c差异无统计学意义(P>0.05),但HDL-C、FPG、hs-CRP、GSP、NIHSS评分、ASPECT评分差异有统计学意义(P<0.05)。经过多因素分析后得到,HDL-C、FPG、hs-CRP、GSP是促进2型糖尿病合并脑梗死患者发生氯吡格雷抵抗的临床危险因素(P<0.05)。结论虽然氯吡格雷在治疗2型糖尿病合并脑梗死方面运用多年,但不同个体对该药物的反应存在差异,即出现氯吡格雷抵抗现象,导致疗效降低,高水平的FPG、hs-CRP、GSP、低水平的HDL-C以及严重的脑梗死程度是促进氯吡格雷抵抗现象发生的危险因素,临床治疗此类患者应注重对症治疗以及适当增加氯吡格雷剂量。
Objective To analyze the clinical risk factors of clopidogrel resistance in patients with type 2 diabetes and cerebral infarction.Methods Sixty patients with type 2 diabetes and cerebral infarction who were admitted to Heping County People's Hospital from March 2019 to February 2021 were selected as the research objects.The 60 selected patients were divided into groups according to the platelet aggregation rate.Patients with clopidogrel resistance were included in the study group,and those without clopidogrel resistance were included in the control group.There were 30 patients in each group.The epidemiological indexes,blood lipid related indicators,blood glucose-related indexes,high-sensitivity C-reactive protein,NIHSS score and ASPECT score were compared between the two groups of patients.Results There were no statistically significant differences in epidemiological indicators(age,gender,smoking history,drinking history,hypertension,coronary heart disease),TC,LDL-C,TG,HbA1c between the two groups of patients(P>0.05),but there were statistically significant differences in HDL-C,FPG,hs-CRP,GSP,NIHSS score,and ASPECT score(P<0.05).After multi-factor analysis,HDL-C,FPG,hs-CRP,and GSP are clinical risk factors that promote clopidogrel resistance in patients with type 2 diabetes and cerebral infarction(P<0.05).Conclusion Although clopidogrel has been used in the treatment of type 2 diabetes with cerebral infarction for many years,different individuals have different responses to the drug,that is,clopidogrel resistance appears,resulting in reduced efficacy,and high levels of FPG,hs-CRP,GSP,low levels of HDL-C,and severe cerebral infarction are risk factors that promote clopidogrel resistance.The clinical treatment of such patients should focus on symptomatic treatment and appropriately increase the dose of clopidogrel.
作者
刘文志
叶逻湾
熊锦科
LIU Wenzhi;YE Luowan;XIONG Jinke(Department of Internal Medicine,Heping County People's Hospital of Guangdong Province,Heping,Guangdong Province,517200 China)
出处
《糖尿病新世界》
2021年第7期14-16,共3页
Diabetes New World Magazine
基金
河源市社会发展科技计划项目(190705081503729)。
关键词
2型糖尿病
脑梗死
氯吡格雷抵抗
危险因素
Type 2 diabetes
Cerebral infarction
Clopidogrel resistance
Risk factors
