摘要
目的探讨经皮冠状动脉介入术(PCI)后的冠心病合并2型糖尿病(T2DM)老年患者氯吡格雷抵抗(CR)的危险因素。方法选取2017年1月至2018年1月于本院择期行PCI的冠心病合并T2DM老年患者152例,依据血栓弹力图检测结果分为观察组(氯吡格雷抵抗组,抑制率<50%)和对照组(非氯吡格雷抵抗组,抑制率>50%),对比两组患者一般临床情况、糖代谢、脂代谢、炎症指标。结果观察组共58例,占总例数38%。观察组既往血栓史比率明显高于对照组;观察组高密度脂蛋白胆固醇(HDL-C)水平明显低于对照组,空腹血糖(FPG)、糖化血清蛋白(GSP)、超敏C反应蛋白(hs-CRP)水平明显高于对照组(均P<0.05)。结论冠心病合并T2DM老年患者存在明显的氯吡格雷抵抗现象,既往血栓史、FPG、GSP、hs-CRP水平升高与HDL-C水平下降可能是老年患者氯吡格雷抵抗的危险因素。
Objective To investigate the risk factors of clopidogrel resistance (CR) in elderly patients with coronary heart disease complicated diabetes( T2DM)treated with percutaneous coronary intervention (PCI). Methods 152 elderly patients with coronary heart disease complicated with T2DM who underwent elective PCI in our hospital from January 2017 to January 2018 were selected. The patients were divided into two groups according to thrombelastogram test: the study group (clopidogrel resistance group, inhibition rate <50%) and the control group (non-clopidogrel resistance group, inhibition rate >50%). The general characteristics, lipid and glucose metabolic indices, inflammation indices were compared with after PCI between two groups. Results There were 58 cases in the observation group, accounting for 38%. The patients in study group had higher historical thrombus incidence rate, lower level of high density lipoprotein cholesterol (HDL-C), higher levels of fasting glucose (FPG), glucosylated serum protein (GSP) and high sensitivity C reactive protein (hs-CRP) than patients in control group (P<0.05 for all). Conclusion Elderly patients with coronary heart disease complicated with T2DM have obvious clopidogrel resistance. Previous thrombus history, increased levels of FPG, GSP, hs-crp and decreased levels of hdl-c may be risk factors for clopidogrel resistance in elderly patients.
作者
符少萍
陈焕清
洪俊
杨雪梅
陈玉成
Fu Shaoping;Chen Huanqing;Hong Jun;Yang Xuemei;Chen Yucheng(Department of Preventive Health Care, the SUN Yat-sen Memorial Hospital of SUN Yat-sen University,Guangzhou, Guangdong, 510120, China)
出处
《当代医学》
2019年第30期88-90,共3页
Contemporary Medicine
关键词
冠心病
糖尿病
老年
冠脉介入
氯吡格雷抵抗
Coronary heart disease
Diabetes
Elder
Percutaneous coronary intervention
Clopidogrel resistance
