CAJ | 학술논문

目的：探讨西洛他唑与氯吡格雷对糖尿病患者血小板聚集率的作用及其可能影响因素。方法选择糖尿病患者1153例，随机分为西洛他唑组（n=577）和氯吡格雷组（n=576），分别在治疗前及治疗1周后测定血小板聚集率，比较2组患者治疗前后血小板聚集率的变化差异，以及比较血脂、空腹血糖、空腹胰岛素、糖化血红蛋白、胰岛素使用剂量对血小板聚集率的影响。结果(1)西洛他唑组服药前后血小板聚集率变化为(18.77±16.57)，氯吡格雷组服药前后血小板聚集率变化为(20.92±14.03)，2组血小板聚集率变化比较,差异无统计学意义，氯吡格雷与西洛他唑疗效相同。(2)甘油三酯、胰岛素使用剂量均为西洛他唑抵抗发生的独立危险因素，低密度脂蛋白、胰岛素使用剂量为氯吡格雷抵抗发生的独立危险因素。结论对于糖尿病患者使用西洛他唑预防心脑血管事件优于氯吡格雷。
목적：탐토서락타서여록필격뢰대당뇨병환자혈소판취집솔적작용급기가능영향인소。방법선택당뇨병환자1153례，수궤분위서락타서조（n=577）화록필격뢰조（n=576），분별재치료전급치료1주후측정혈소판취집솔，비교2조환자치료전후혈소판취집솔적변화차이，이급비교혈지、공복혈당、공복이도소、당화혈홍단백、이도소사용제량대혈소판취집솔적영향。결과(1)서락타서조복약전후혈소판취집솔변화위(18.77±16.57)，록필격뢰조복약전후혈소판취집솔변화위(20.92±14.03)，2조혈소판취집솔변화비교,차이무통계학의의，록필격뢰여서락타서료효상동。(2)감유삼지、이도소사용제량균위서락타서저항발생적독립위험인소，저밀도지단백、이도소사용제량위록필격뢰저항발생적독립위험인소。결론대우당뇨병환자사용서락타서예방심뇌혈관사건우우록필격뢰。
Objective To investigate the effect of clopidogrel and cilostazol on the rate of platelet aggregation(RPA) in patients with type 2 diabetes and the possible factors that influence their effect. Methods 1153 patients with type 2 diabetes were randomly divided into two groups, the clopidogrel group (n=576) and the cilostazol group (n=577). RPA was examined on baseline and one week after medication. We compared RPA between two groups and analysed their risk fators affecting PRA such as lipids, fasting glucose, fasting insulin, glycosylated hemoglobin, the dosage of insulin. Results (1) The change of RPA before and after medication was (20.92 ± 14.03) in clopidogrel group, and in cilostazol group was (18.77±16.57).The change of RPA between two groups was no significant difference, suggesting that Clopidogrel and cilostazol have the same effect on PRA;(2) For risk fators , we found that low-density lipoprotein, insulin dose were independent risk factors in occurrence of clopidogrel resistance,while triglycerides, insulin dose of were independent risk factors in occurrence of cilostazol resistance. Conclusion Use Cilostazol preventing cardiocerebrovascular events is superior to clopidogrel for diabetes.