CAJ | 학술논문

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。
목적：료해당뇨병(DM)대급성심기경사(AMI)환자PCI술후혈소판대록필격뢰반응성적영향。방법：선택아원주원적AMI환자80례,기중급성ST단태고형심기경사35례,비ST단태고형심기경사45례。입원후균급여표준쌍련항혈소판치료,7천후응용혈전탄력도의측정이린산선감(ADP)유도적혈소판억제솔,억제솔저우20%정의위록필격뢰반응불량,20%～50%위반응저하,대우50%위반응량호。근거시부합병DM,장환자분위DM조화비DM조,비교량조환자ADP유도적혈소판억제솔적차이。결과：80례AMI환자중합병DM환자28례,비DM환자52례,전자ADP유도적혈소판억제솔위(40.5±14.2)%,후자(61.7±21.6)%,량자차이용통계학의의(P<0.05)。합병DM적환자록필격뢰반응불량비례고우비DM환자(28.6%v 19.2%),량조구유명현통계학차이(P<0.05)。결론：DM강저AMI환자혈소판대록필격뢰적반응성。
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<0.05). The proportion of lower response to clopidogrel in patients with DM is larger than that of non-diabetic patients(28.6%v 19.2%),there was distinct significant change in two groups(P<0.05). Conclusion:DM reduces the response of platelet to clopidogrel in patients with AMI after PCI.