老年糖尿病患者发生阿司匹林抵抗的情况及相关因素分析

Aspirin Resistance in Elderly Patients with Type 2 Diabetes and Analysis of Related Factors

中文关键词: 血栓弹力图  糖尿病  血小板抑制率  阿司匹林抵抗

英文关键词: thrombelastogram (TEG)  diabetes  platelet inhibition rate  aspirin resistance (AR)

中文摘要:

      目的 观察老年2型糖尿病患者发生阿司匹林抵抗(AR)的情况并探讨相关影响因素.方法 选取200例复旦大学附属中山医院老年病科住院患者,根据WHO1999年的糖尿病诊断标准,分为糖尿病组和非糖尿病组.糖尿病组患者根据糖化血红蛋白(HbA1c)水平分为血糖控制良好组(HbA1c≤7％)和血糖控制不佳组(HbA1c＞7％).依据血栓弹力图(TEG)检测阿司匹林药物抑制率的结果,比较各组患者发生(ARC药物抑制率≤50％)和阿司匹林敏感(AS,药物抑制率＞50％)的情况,并分析糖尿病患者发生AR的相关因素.结果 糖尿病患者AR发生率高于非糖尿病者(68.8％VS 51.9％,P＜0.05),且血糖控制不佳者更易发生AR.性别(OR=4.402,95％ CI=0.987 ～ 7.894,P＜0.05)和低密度脂蛋白胆固醇(LDL-C)(OR=3.956,95％ CI=0.842～9.625,P＜0.05)与老年2型糖尿病患者发生AR密切相关.结论 老年2型糖尿病患者较非糖尿病患者更易发生AR,性别和LDL-C水平与糖尿病患者是否发生AR密切相关.

英文摘要:

      Objective To observe the occurrence of aspirin resistance (AR) in elderly patients with type 2 diabetes and to explore the related factors.Methods 200 elderly patients hospitalized in Department of Geriatrics were divided into 2 groups according to the diagnostic criteria for diabetes (WHO 1999):diabetes group and non-diabetes group,diabetes group was subdivided according to the level of HbAlc into 2 subgroups:good glucose control group (HbA1c≤7％) and poorglucose control group (HbA1c ＞ 7％),the platelet inhibition rate was determined by thrombelastogram (TEG),AR was defined as inhibition rate ≤ 50％ while aspirin sensitivity (AS) was defined as inhibition rate ＞ 50 ％,the occurrences of AR and AS in each group were compared and the related factors for AR in patients with diabetes was analyzed.Results The occurrence of AR in patients with diabetes were higher than that in patients with no diabetes (68.8％ vs 51.9％,P＜0.05) and the patients with poor glucose control were more prone to have AR;gender (OR=4.402,95％ CI=0.987-7.894,P＜0.05) and the level of LDL-C (OR =3.956,95 ％ CI =0.842-9.625,P ＜ 0.05) were closely related to the occurrence of AR in elderly patients with type 2 diabetes.Conclusions The elderly patients with type 2 diabetes are more likely to have AR than the elderly with no diabetes;gender and the level of LDL-C are the relative risk factors for AR occurrence in patients with diabetes.