冠心病患者阿司匹林抵抗的危险因素分析(1)
[摘要]目的 研究冠心病患者阿司匹林抵抗的危险因素。方法 回顾性分析我院2012年1月～2017年4月收治的冠心病患者的临床资料，按纳入与排除标准分别筛选发生阿司匹林抵抗(AR组)与未发生AR患者(NAR组)各40例，比较两组患者的一般临床资料及相关实验室指标，分析冠心病患者发生AR的危险因素。结果AR组的视黄醇结合蛋白(RBP)水平低于NAR组，肌酐(SCr)、Hcy、CD62P水平高于NAR组，差异有统计学意义(P<0.05)。以是否发生AR为自变量，Hcy、CD62P均为冠心病患者发生AR的危险因素，以Hcy危险值最高。结论 Hcy、CD62P均为冠心病患者发生AR的危险因素，或可成为预估冠心病患者发生AR风险的有效指标。
[关键词]阿司匹林抵抗；冠心病；危险因素
[中图分类号] R541.4 [文献标识码] A [文章编号] 1674-4721(2018)4(a)-0056-03
Analysis of risk factors of aspirin resistance in patients with coronary heart disease
ZHOU Li-yao GUO Jian-hao LI Jian-ping CHEN Ruo-feng WANG Jia
Department of Cardiovascular Medicine，Beijiao Hospital of Shunde District in Foshan City，Guangdong Province，Foshan 528311，China
[Abstract]Objective To study the risk factors of aspirin resistance in patients with coronary heart disease (CHD).Methods The clinical data of patients with CHD admitted into our hospital from January 2012 to April 2017 were retrospectively analyzed.According to inclusion and exclusion criteria，40 patients with aspirin resistance (AR group) or without AR (NAR group) were screened respectively.The general clinical data and the related laboratory indexes were compared between the two groups，and the risk factors of AR in patients with CHD were analyzed.Results The level of retinol-binding protein (RBP) in the AR group was lower than that in the NAR group while the level of creatinine (SCr)，Hcy and CD62P were higher than those in the NAR group (P<0.05).Taken AR as the dependent variable，the Hcy and CD62P were risk factors for AR in patients with CHD，and the risk value of Hcy was highest.Conclusion Hcy and CD62P are the risk factors for AR in patients with CHD，or it can be an effective index in the predicting the AR risk in patients with CHD.
[Key words]Aspirin resistance；Coronary heart disease；Risk factors
阿司匹林作为治疗血栓栓塞性疾病的广普用药，对冠心病患者心血管的保护作用已得到临床证实，但有研究表明，阿司匹林的抗血小板聚集机制并非适用于所有患者，部分患者使用经常规剂量或大剂量阿司匹林治疗后，仍难以获得抑制血小板聚集及血栓素生物合成获益，并发生血栓栓塞事件，临床称之为阿司匹林抵抗(AR)[1]。而血浆同型半胱氨酸(Hcy)为预测心血管事件发生风险的敏感生化指标[2]，本研究旨在通过回顾性分析方式，进一步补充及完善AR對冠心病患者血浆Hcy水平的影响，现报道如下。
1资料与方法
1.1一般资料
将我院2012年1月～2017年4月收治的冠心病患者纳入研究，按纳入与排除标准分别筛选发生阿司匹林抵抗(AR)与未发生AR的患者各40例，分别为阿司匹林抵抗组(AR组)与非阿司匹林抵抗组(NAR组)。本研究已通过医院伦理委员会批准，且所有患者均知情研究内容并签署同意书。两组的一般临床资料比较见表1。
1.2纳入与排除标准
纳入标准：①符合冠心病诊断要求，且病情平稳；②标准化(100 mg/d)阿司匹林治疗时长﹥30 d；③发生AR的患者均符合AR诊断要求[3](ADP诱导血小板聚集率≥70%且AA诱导血小板聚集率≥20%)；④无阿司匹林过敏史。
排除标准：①入组前有非甾体类抗炎药物或肝素钠或瑞肝素钠使用史；②入组前2周内有重大外科手术史；③血液性疾病，如骨髓增殖性疾病等；④药物性血小板减少症；⑤实验室指标，如血红蛋白<8 g/L。, 百拇医药(周立尧 郭建浩 李剑平 陈若峰 王佳)
[关键词]阿司匹林抵抗；冠心病；危险因素
[中图分类号] R541.4 [文献标识码] A [文章编号] 1674-4721(2018)4(a)-0056-03
Analysis of risk factors of aspirin resistance in patients with coronary heart disease
ZHOU Li-yao GUO Jian-hao LI Jian-ping CHEN Ruo-feng WANG Jia
Department of Cardiovascular Medicine，Beijiao Hospital of Shunde District in Foshan City，Guangdong Province，Foshan 528311，China
[Abstract]Objective To study the risk factors of aspirin resistance in patients with coronary heart disease (CHD).Methods The clinical data of patients with CHD admitted into our hospital from January 2012 to April 2017 were retrospectively analyzed.According to inclusion and exclusion criteria，40 patients with aspirin resistance (AR group) or without AR (NAR group) were screened respectively.The general clinical data and the related laboratory indexes were compared between the two groups，and the risk factors of AR in patients with CHD were analyzed.Results The level of retinol-binding protein (RBP) in the AR group was lower than that in the NAR group while the level of creatinine (SCr)，Hcy and CD62P were higher than those in the NAR group (P<0.05).Taken AR as the dependent variable，the Hcy and CD62P were risk factors for AR in patients with CHD，and the risk value of Hcy was highest.Conclusion Hcy and CD62P are the risk factors for AR in patients with CHD，or it can be an effective index in the predicting the AR risk in patients with CHD.
[Key words]Aspirin resistance；Coronary heart disease；Risk factors
阿司匹林作为治疗血栓栓塞性疾病的广普用药，对冠心病患者心血管的保护作用已得到临床证实，但有研究表明，阿司匹林的抗血小板聚集机制并非适用于所有患者，部分患者使用经常规剂量或大剂量阿司匹林治疗后，仍难以获得抑制血小板聚集及血栓素生物合成获益，并发生血栓栓塞事件，临床称之为阿司匹林抵抗(AR)[1]。而血浆同型半胱氨酸(Hcy)为预测心血管事件发生风险的敏感生化指标[2]，本研究旨在通过回顾性分析方式，进一步补充及完善AR對冠心病患者血浆Hcy水平的影响，现报道如下。
1资料与方法
1.1一般资料
将我院2012年1月～2017年4月收治的冠心病患者纳入研究，按纳入与排除标准分别筛选发生阿司匹林抵抗(AR)与未发生AR的患者各40例，分别为阿司匹林抵抗组(AR组)与非阿司匹林抵抗组(NAR组)。本研究已通过医院伦理委员会批准，且所有患者均知情研究内容并签署同意书。两组的一般临床资料比较见表1。
1.2纳入与排除标准
纳入标准：①符合冠心病诊断要求，且病情平稳；②标准化(100 mg/d)阿司匹林治疗时长﹥30 d；③发生AR的患者均符合AR诊断要求[3](ADP诱导血小板聚集率≥70%且AA诱导血小板聚集率≥20%)；④无阿司匹林过敏史。
排除标准：①入组前有非甾体类抗炎药物或肝素钠或瑞肝素钠使用史；②入组前2周内有重大外科手术史；③血液性疾病，如骨髓增殖性疾病等；④药物性血小板减少症；⑤实验室指标，如血红蛋白<8 g/L。, 百拇医药(周立尧 郭建浩 李剑平 陈若峰 王佳)