医学综述
醫學綜述
의학종술
MEDICAL RECAPITULATE
2014年
24期
4578-4579,4580
,共3页
老年冠心病%氯吡格雷抵抗%血栓弹力图
老年冠心病%氯吡格雷牴抗%血栓彈力圖
노년관심병%록필격뢰저항%혈전탄력도
Elderly patients with coronary heart disease%Clopidogrel resistance%Blood platelet
目的：研究老年冠状动脉粥样硬化性心脏病(冠心病)患者经皮冠状动脉介入术( PCI)后氯吡格雷抵抗的影响因素。方法将2009年1月至2012年12月间福建医科大学附属龙岩第一医院收治的146例老年冠心病患者根据血栓弹力图检测结果分为抵抗组和敏感组,均使用氯吡格雷抗血小板治疗,比较两组患者各因素对氯吡格雷抵抗的影响。结果 Logistic回归分析结果显示氯吡格雷抵抗的独立危险因素有女性(OR=3.462,95%CI 1.415~7.962),吸烟史(OR=4.941,95%CI 1.245~21.762),糖尿病史(OR=3.253,95%CI1.374~7.592),空腹血糖≥11.1 mmol/L(OR=2.176,95%CI1.073~4.632),糖化血红蛋白≥7%(OR=3.715,95%CI1.826~7.472),肌钙蛋白≥0.13 mkg/L(OR=5.642,95%CI2.934~9.758),三酰甘油≥2.26 mmol/L(OR=2.694,95%CI1.634~4.938)。结论性别因素、行为因素、以及生化因素是造成氯吡格雷抵抗的主要原因,需要采取差异化抗凝治疗。
目的：研究老年冠狀動脈粥樣硬化性心髒病(冠心病)患者經皮冠狀動脈介入術( PCI)後氯吡格雷牴抗的影響因素。方法將2009年1月至2012年12月間福建醫科大學附屬龍巖第一醫院收治的146例老年冠心病患者根據血栓彈力圖檢測結果分為牴抗組和敏感組,均使用氯吡格雷抗血小闆治療,比較兩組患者各因素對氯吡格雷牴抗的影響。結果 Logistic迴歸分析結果顯示氯吡格雷牴抗的獨立危險因素有女性(OR=3.462,95%CI 1.415~7.962),吸煙史(OR=4.941,95%CI 1.245~21.762),糖尿病史(OR=3.253,95%CI1.374~7.592),空腹血糖≥11.1 mmol/L(OR=2.176,95%CI1.073~4.632),糖化血紅蛋白≥7%(OR=3.715,95%CI1.826~7.472),肌鈣蛋白≥0.13 mkg/L(OR=5.642,95%CI2.934~9.758),三酰甘油≥2.26 mmol/L(OR=2.694,95%CI1.634~4.938)。結論性彆因素、行為因素、以及生化因素是造成氯吡格雷牴抗的主要原因,需要採取差異化抗凝治療。
목적：연구노년관상동맥죽양경화성심장병(관심병)환자경피관상동맥개입술( PCI)후록필격뢰저항적영향인소。방법장2009년1월지2012년12월간복건의과대학부속룡암제일의원수치적146례노년관심병환자근거혈전탄력도검측결과분위저항조화민감조,균사용록필격뢰항혈소판치료,비교량조환자각인소대록필격뢰저항적영향。결과 Logistic회귀분석결과현시록필격뢰저항적독립위험인소유녀성(OR=3.462,95%CI 1.415~7.962),흡연사(OR=4.941,95%CI 1.245~21.762),당뇨병사(OR=3.253,95%CI1.374~7.592),공복혈당≥11.1 mmol/L(OR=2.176,95%CI1.073~4.632),당화혈홍단백≥7%(OR=3.715,95%CI1.826~7.472),기개단백≥0.13 mkg/L(OR=5.642,95%CI2.934~9.758),삼선감유≥2.26 mmol/L(OR=2.694,95%CI1.634~4.938)。결론성별인소、행위인소、이급생화인소시조성록필격뢰저항적주요원인,수요채취차이화항응치료。
Objective Investigate the prevalence and influential factors of clopidogrel resistance on eld-erly patients with coronary heart disease. Methods A lolal of 146 patients with coronary heart disease trea-ted with aspirin and clopidogrel after PCI were enrolled, and were examined with fasting thrombelastography 3 d after PCT. Patients were divided into clopidogrel resistance group and clopidogrel sensitive group accord-ing to adenosine diphosphate-induced platelet aggregation inhibition rate. The imaging characteristics bio-chemical parameters and general clinical data,were compared between two groups,and the independent risk factors of clopidogrel resistance were explored by Logistic regression analysis. Results Logistic regression a-nalysis revealed that female(OR=3.462,95%CI 1.415~7.962),history of smoking(OR=4.941,95%CI 1.245~21. 762),history of diabetes(OR =3. 253,95%CI 1. 374~7. 592),fasting blood-glucose≥11. 1mmol/L(OR=2. 176,95%CI 1. 073~4. 632),glycosylated hemoglobin≥7%(OR=3. 715,95%CI 1. 826~7.472), troponin≥0.13 mkg/LOR=5.642,95%CI 2.934~9.758)and triacylglycerol≥2.26 mmol/LOR=2. 694,95%CI 1. 634~4. 938)were independent risk factors of clopidogrel resistance. Conclusion Female gender,diabetes,smoking,high blood lipids and myocardial enzyme elevation might be risk factors of clopidogrel resistance in patients with coronary heart disease after PCI.
