2 型糖尿病合并冠心病患者氯吡格雷抵抗的危险因素

目的观察老年2型糖尿病合并冠心病患者发生氯吡格雷抵抗的情况，探讨分析相应的危险因素。方法选择本院2011年7月—2013年7月期间收治的76例老年2型糖尿病合并冠心病患者作为观察对象，根据血小板聚集试验结果进行分组，其中血小板抑制率〉50％共40例（对照组），〈50％共36例（观察组），对比2组流行病学、脂代谢、糖代谢与超敏C反应蛋白等水平值。结果2组患者年龄、性别、体重、高脂血症与高血压发病史以及吸烟史等流行病学指标对比，差异均不具有统计学意义（均P〉0．05）；观察组空腹血糖、超敏C反应蛋白显著高于对照组，而高密度脂蛋白胆固醇显著低于对照组，差异均具有统计学意义（均P〈0．05）；经多因素分析后，高密度脂蛋白胆固醇、空腹血糖、超敏c反应蛋白均是影响患者发生氯吡格雷抵抗的危险因素（均P〈0．05）。结论老年2型糖尿病合并冠心病患者出现氯吡格雷抵抗的发生率大，且与患者的空腹血糖水平、高密度脂蛋白胆固醇、超敏C反应蛋白等因素有关，值得临床上进一步分析。

Analysis of clopidogrel resistance and related risk factors for elderly type 2 diabetes mellitus patients complicated with coronary heart disease

Objective To observe the occurrence of clopidogrel resistance in patients with elderly type 2 diabetic patients with coronary heart disease, and to explore the risk factors of the corresponding. Methods 76 cases of elderly type 2 diabetes mellitus patients complicated with coronary heart disease admitted to our hospital from July 2011 to July 2013 were selected as the object of observation, and according to platelet agglutination test results they were grouped, among them forty cases with the inhibitory rate of blood platelet greater than 50% were control group and a total of thirty-six cases less than 50% were the observation group, value of epidemiology,lipid metabolism, glucose metabolism and high-sensitivity C reactive protein in two groups were compared. Results Comparison of the two groups in age, sex, body weight, hyperlipidemia and the history of hypertension and smoking history epidemiological indicators, the difference was not statistically significant（ P 〉0.05 ） ;while the fasting blood glucose and high sensitive C reactive protein in observation group were significantly higher than those in control group, and high density lipoprotein cholesterol was significantly lower than that of the control group ,the difference was statistically significant（ P 〈 0.05 ） ;by multiple factor analysis, high density lipoprorein cholesterol ,fasting blood glucose and high sensitive C reactive protein were risk factors of clopidogrel resistance in patients（ P 〈 0.05 ）. Conclusion In elderly patients with type 2 diabetes mellitus complicated with coronary heart disease appearing the prevalence of clopidogrel resistance was relatively large, and that relevant factors were the level of fasting blood glucose, high density lipoprotein cholesterol, high sensitive C reactive protein and others, so it was worthy of further clinical analysis.