中国医药
中國醫藥
중국의약
CHINA MEDICINE
2013年
11期
1524-1526
,共3页
郭欣君%任志亮%赵颖超%格日勒
郭訢君%任誌亮%趙穎超%格日勒
곽흔군%임지량%조영초%격일륵
冠心病%阿司匹林%抵抗%血小板聚集
冠心病%阿司匹林%牴抗%血小闆聚集
관심병%아사필림%저항%혈소판취집
Coronary heart disease%Aspirin%Resistance%Platelet aggregation
目的 探讨冠心病稳定型心绞痛患者阿司匹林抵抗(AR)的发生率,并分析该类患者的临床特征,便于临床上早期发现AR,改善该类患者的治疗现状.方法 选择内蒙古自治区人民医院心内科2011年1月至2012年5月住院冠心病患者200例,所有患者于每日早饭后顿服拜阿司匹林片100 mg,连续服用10 d后抽取肘静脉血,分别用花生四烯酸和二磷酸腺苷为诱导剂诱导血小板聚集,根据患者对阿司匹林的反应情况将患者分为AR+阿司匹林半抵抗组(50例),其中AR组(10例)、阿司匹林半抵抗组(40例),阿司匹林敏感组(150例),同时送检生化全项,对各项临床特征的组间差异进行对比分析.结果 AR组、阿司匹林半抵抗组、AR+阿司匹林半抵抗组、阿司匹林敏感组的AR发生率分别为5％ (10/200)、20％(40/200)、25％ (50/200)、75％ (150/200).AR+阿司匹林半抵抗组合并糖尿病例数、WBC、TC、TG、LDL-C、BMI等指标[16例、(5.4±2.0)×109/L、(5.5±1.6) mmol/L、(3.0±0.5) mmol/L、(3.0±1.4) mmol/L、(25.3±1.9) kg/m2]与阿司匹林敏感组[12例、(4.6±0.6)×109/L、(4.7±1.0) mmol/L、(2.0±1.4) mmol/L、(2.6±0.9) mmol/L、(24.0±2.0)kg/m2]比较,差异均有统计学意义(P＜0.05或P＜0.01).结论 AR现象可能与血糖、血脂、体重指数、白细胞计数增高等因素有关,在这些状态下应警惕AR的发生,必要时增加剂量或应用其他药物替代治疗.
目的 探討冠心病穩定型心絞痛患者阿司匹林牴抗(AR)的髮生率,併分析該類患者的臨床特徵,便于臨床上早期髮現AR,改善該類患者的治療現狀.方法 選擇內矇古自治區人民醫院心內科2011年1月至2012年5月住院冠心病患者200例,所有患者于每日早飯後頓服拜阿司匹林片100 mg,連續服用10 d後抽取肘靜脈血,分彆用花生四烯痠和二燐痠腺苷為誘導劑誘導血小闆聚集,根據患者對阿司匹林的反應情況將患者分為AR+阿司匹林半牴抗組(50例),其中AR組(10例)、阿司匹林半牴抗組(40例),阿司匹林敏感組(150例),同時送檢生化全項,對各項臨床特徵的組間差異進行對比分析.結果 AR組、阿司匹林半牴抗組、AR+阿司匹林半牴抗組、阿司匹林敏感組的AR髮生率分彆為5％ (10/200)、20％(40/200)、25％ (50/200)、75％ (150/200).AR+阿司匹林半牴抗組閤併糖尿病例數、WBC、TC、TG、LDL-C、BMI等指標[16例、(5.4±2.0)×109/L、(5.5±1.6) mmol/L、(3.0±0.5) mmol/L、(3.0±1.4) mmol/L、(25.3±1.9) kg/m2]與阿司匹林敏感組[12例、(4.6±0.6)×109/L、(4.7±1.0) mmol/L、(2.0±1.4) mmol/L、(2.6±0.9) mmol/L、(24.0±2.0)kg/m2]比較,差異均有統計學意義(P＜0.05或P＜0.01).結論 AR現象可能與血糖、血脂、體重指數、白細胞計數增高等因素有關,在這些狀態下應警惕AR的髮生,必要時增加劑量或應用其他藥物替代治療.
목적 탐토관심병은정형심교통환자아사필림저항(AR)적발생솔,병분석해류환자적림상특정,편우림상상조기발현AR,개선해류환자적치료현상.방법 선택내몽고자치구인민의원심내과2011년1월지2012년5월주원관심병환자200례,소유환자우매일조반후돈복배아사필림편100 mg,련속복용10 d후추취주정맥혈,분별용화생사희산화이린산선감위유도제유도혈소판취집,근거환자대아사필림적반응정황장환자분위AR+아사필림반저항조(50례),기중AR조(10례)、아사필림반저항조(40례),아사필림민감조(150례),동시송검생화전항,대각항림상특정적조간차이진행대비분석.결과 AR조、아사필림반저항조、AR+아사필림반저항조、아사필림민감조적AR발생솔분별위5％ (10/200)、20％(40/200)、25％ (50/200)、75％ (150/200).AR+아사필림반저항조합병당뇨병례수、WBC、TC、TG、LDL-C、BMI등지표[16례、(5.4±2.0)×109/L、(5.5±1.6) mmol/L、(3.0±0.5) mmol/L、(3.0±1.4) mmol/L、(25.3±1.9) kg/m2]여아사필림민감조[12례、(4.6±0.6)×109/L、(4.7±1.0) mmol/L、(2.0±1.4) mmol/L、(2.6±0.9) mmol/L、(24.0±2.0)kg/m2]비교,차이균유통계학의의(P＜0.05혹P＜0.01).결론 AR현상가능여혈당、혈지、체중지수、백세포계수증고등인소유관,재저사상태하응경척AR적발생,필요시증가제량혹응용기타약물체대치료.
Objective To discuss the occurrence rate of aspirin resistance (AR) in patients with stable angina pectoris of coronary heart disease ; to evaluate the clinical characteristics of them; to facilitate early detection of clinical AR and improve the present status of treatment.Methods Totally 200 paients with coronary heart disease in the department of cardiology in the People's Hospital of Inner Mongolia Autonomous Region from January 2011 to May 2012 were selected.All patients were given aspirin (100 mg/d for 10 days) after breakfast,and then the blood samples were collected for determination of optical platelet aggregation index using arachidonic acid (AA) and adenosine diphosphate (ADP).All patients were divided into AR + aspirin semi-resistance group (50 cases),aspirin resistance (AR) group (10 cases),aspirin semi-resistance group (40 cases) and aspirin sensitive group (150 ca-ses) according to the antiplatelet effect of aspirin.The differences in clinical characteristics among the groups and associated factors were analyzed.Results Aspirin resistance occurrence rate of AR group,AR + aspirin semi-resistance group,aspirinsemi-resistance group and aspirin sensitive group was 5％ (10/200),20％ (40/200),25％ (50/200) and 75％ (150/200).There were significant differences on the number of cases with diabetes mellitus,white blood cell (WBC),total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),body mass index (BMI) between AR + aspirin emi-resistance group and aspirin sensitive group [AR + aspirin semiresistance group:16 cases,(5.4 ± 2.0) × 109/L,(5.5 ± 1.6) mmol/L,(3.0 ± 0.5) mmol/L,(3.0 ± 1.4) mmol/L,(25.3 ± 1.9) kg/m2 ; aspirin sensitive group:12 cases,(4.6 ± 0.6) × 109/L,(4.7 ± 1.0) mmol/L,(2.0 ±1.4) mmol/L,(2.6 ± 0.9) mmol/L,(24.0 ± 2.0) kg/m2] (P ＜ 0.05 or P ＜ 0.01).Conclusion Aspirin resistance is likely correlated with some clinical such as diabetes mellitus,hyperlipodemia,BMI and WBC.
