中国全科医学
中國全科醫學
중국전과의학
Chinese General Practice
2015年
34期
4192-4195
,共4页
冠心病%残余血小板高反应性%影响因素分析
冠心病%殘餘血小闆高反應性%影響因素分析
관심병%잔여혈소판고반응성%영향인소분석
Coronary disease%High residual platelet reactivity%Root cause analysis
目的：探讨冠心病患者发生氯吡格雷治疗后残余血小板高反应性（残余血小板高反应性）的影响因素。方法选取2014年1—12月到广东省中医院住院治疗的冠心病患者513例。根据是否发生残余血小板高反应性，将患者分为高反应性组（n＝125）和非高反应性组（n＝388）。采用查询病历法，收集患者的一般资料，包括住院号、姓名、性别、年龄、吸烟史、BMI、冠心病类型、合并症、用药情况、左主干病变情况、病变血管数量、血小板聚集率及糖化血红蛋白（ HbA1c ）水平等。结果单因素分析显示，不同BMI、冠心病类型、糖尿病合并情况、血管病变≥3支患者的残余血小板高反应性发生率比较，差异有统计学意义（ P﹤0.05）；不同性别、年龄、吸烟史、高血压合并情况、高脂血症合并情况、质子泵抑制剂使用情况、他汀类药物使用情况、左主干病变情况患者的残余血小板高反应性发生率比较，差异无统计学意义（ P﹥0.05）。多因素非条件Logistic回归分析显示，BMI、冠心病类型、糖尿病合并情况、血管病变≥3支对冠心病患者发生残余血小板高反应性的影响有统计学意义（ P﹤0.05）。Pearson相关分析显示，HbA1c和血小板聚集率呈正相关关系（r＝0.59，P﹤0.05）。结论 BMI、冠心病类型、糖尿病合并情况、血管病变≥3支是冠心病患者发生残余血小板高反应性的影响因素，且HbA1c越高，血小板聚集率越高，残余血小板高反应性越强。
目的：探討冠心病患者髮生氯吡格雷治療後殘餘血小闆高反應性（殘餘血小闆高反應性）的影響因素。方法選取2014年1—12月到廣東省中醫院住院治療的冠心病患者513例。根據是否髮生殘餘血小闆高反應性，將患者分為高反應性組（n＝125）和非高反應性組（n＝388）。採用查詢病歷法，收集患者的一般資料，包括住院號、姓名、性彆、年齡、吸煙史、BMI、冠心病類型、閤併癥、用藥情況、左主榦病變情況、病變血管數量、血小闆聚集率及糖化血紅蛋白（ HbA1c ）水平等。結果單因素分析顯示，不同BMI、冠心病類型、糖尿病閤併情況、血管病變≥3支患者的殘餘血小闆高反應性髮生率比較，差異有統計學意義（ P﹤0.05）；不同性彆、年齡、吸煙史、高血壓閤併情況、高脂血癥閤併情況、質子泵抑製劑使用情況、他汀類藥物使用情況、左主榦病變情況患者的殘餘血小闆高反應性髮生率比較，差異無統計學意義（ P﹥0.05）。多因素非條件Logistic迴歸分析顯示，BMI、冠心病類型、糖尿病閤併情況、血管病變≥3支對冠心病患者髮生殘餘血小闆高反應性的影響有統計學意義（ P﹤0.05）。Pearson相關分析顯示，HbA1c和血小闆聚集率呈正相關關繫（r＝0.59，P﹤0.05）。結論 BMI、冠心病類型、糖尿病閤併情況、血管病變≥3支是冠心病患者髮生殘餘血小闆高反應性的影響因素，且HbA1c越高，血小闆聚集率越高，殘餘血小闆高反應性越彊。
목적：탐토관심병환자발생록필격뢰치료후잔여혈소판고반응성（잔여혈소판고반응성）적영향인소。방법선취2014년1—12월도광동성중의원주원치료적관심병환자513례。근거시부발생잔여혈소판고반응성，장환자분위고반응성조（n＝125）화비고반응성조（n＝388）。채용사순병역법，수집환자적일반자료，포괄주원호、성명、성별、년령、흡연사、BMI、관심병류형、합병증、용약정황、좌주간병변정황、병변혈관수량、혈소판취집솔급당화혈홍단백（ HbA1c ）수평등。결과단인소분석현시，불동BMI、관심병류형、당뇨병합병정황、혈관병변≥3지환자적잔여혈소판고반응성발생솔비교，차이유통계학의의（ P﹤0.05）；불동성별、년령、흡연사、고혈압합병정황、고지혈증합병정황、질자빙억제제사용정황、타정류약물사용정황、좌주간병변정황환자적잔여혈소판고반응성발생솔비교，차이무통계학의의（ P﹥0.05）。다인소비조건Logistic회귀분석현시，BMI、관심병류형、당뇨병합병정황、혈관병변≥3지대관심병환자발생잔여혈소판고반응성적영향유통계학의의（ P﹤0.05）。Pearson상관분석현시，HbA1c화혈소판취집솔정정상관관계（r＝0.59，P﹤0.05）。결론 BMI、관심병류형、당뇨병합병정황、혈관병변≥3지시관심병환자발생잔여혈소판고반응성적영향인소，차HbA1c월고，혈소판취집솔월고，잔여혈소판고반응성월강。
Objective To explore the influencing factors for high residual platelet reactivity in patients with coronary heart disease after clopidogrel treatment. Methods We enrolled 513 patients with coronary heart disease who were admitted into Guangdong Province Hospital of Traditional Chinese Medicine from January to December in 2014. According to whether high residual platelet reactivity occurred,the patients were divided into two groups:reactivity group(n=125)and non-reactivity group(n =338). Medical record query method was employed,general data were collected,including admission number, name,gender,age,smoking history,BMI,type of coronary heart disease,complications,situation of medication,situation of left main coronary artery lesion,the number of diseased coronary arteries,HbA1c ,etc. Results Univariate analysis showed that patients with different situations of BMI, type of coronary heart disease, complication with diabetes and the number of diseased coronary arteries≥3 were significantly different in the incidence of high residual platelet reactivity(P﹤0. 05);patients with different gender, age, smoking history and different situations of complications with hypertension, complication with hyperlipidaemia,usage of proton pump inhibitor, usage of statins and left main coronary artery lesion were not significantly different in the incidence of high residual platelet reactivity ( P ﹥0. 05 ) . Multivariate non - conditional logistic regression analysis showed that BMI,kind of coronary disease,complication with diabetes,number of diseased coronary arteries≥3 had significant influence on the incidence of high residual platelet reactivity ( P﹤0. 05 ) . Pearson correlation analysis showed that HbA1c was positively correlated with platelet aggregation rate(r=0. 59,P﹤0. 05). Conclusion BMI,type of coronary heart disease,complication with diabetes and triple vessel disease are the risk factors for high residual platelet reactivity in patients with coronary heart disease,higher HbA1c is associated with higher platelet aggregation rate and higher residual platelet reactivity.
