老年人群阿司匹林抵抗及其临床相关因素分析

目的:分析老年人群阿司匹林抵抗(AR)情况及临床相关因素.方法:入选长期服用阿司匹林的汉族老年人(100 mg/d,3个月以上),共300例(男 196例,女 104例),年龄65～84岁.检测分别由二磷酸腺苷和花生四烯酸诱导的血小板聚集率.根据检测结果,将患者分为AR组和阿司匹林敏感(AS)组.记录入选对象性别、年龄、病程、血常规、服用非甾体消炎药及质子泵抑制剂药物史、吸烟史、血脂异常史、糖尿病史.结果:AR组老人红细胞数量、吸烟者、服用非甾体消炎药及质子泵抑制剂者、患高胆固醇血症者百分比高于AS组.Logistic回归分析显示,年龄、性别、吸烟史、红细胞计数对于AR的发生具有独立的影响.结论:在老年人群中,血红细胞数量、服用非甾体消炎药及质子泵抑制剂、吸烟、高胆固醇血症与AR有关.而年龄、性别、吸烟史、红细胞计数是AR发生的独立影响因素.

Aspirin resistance in the elderly and its associated clinical factors

Objective:To investigate the prevalence of aspirin resistance(AR)in the elderly and its risk factors. Method:Three hundred cases of Han elderly people(196 males and 104 females, age of 65-84) who were on long-term aspirin therapy (On aspirin 100mg daily continuously for more than 3 months) were enrolled in the study. Platelet aggregation was determined by adenosine diphosphate(ADP) or arachidonic acid(AA) induction. Patients were divided into AR group and AS group. Recording patient's gender,age, duration of disease,blood routine,concomitant medical therapy,history of smoking, hyperlipidemia and diabetes. Result:Two groups were different in percentage of patients taking non-steroidal anti-inflammatory drugs(NSAID), proton pump inhibitors, smoking and suffering from hypercholesterolaemia. Two groups were significantly different in red blood cells (RBC) counts. Age, gender, smoking, RBC counts were independently related to AR, among which RBC counts had greatest impact. Conclusion:NSAID, proton pump inhibitors, smoking and hypercholesterolaemia were related to AR. Age, gender, smoking and RBC count are independent risk factors for AR.