老年男性心血管病患者阿司匹林抵抗的影响因素

目的探讨老年男性心血管病患者阿司匹林抵抗的发生率及可能的危险因素。方法选择服用阿司匹林（100 mg/d）〉1月的老年男性心血管病患者366例,采用血栓弹力图法进行血小板聚集功能检测,分为阿司匹林抵抗组（22例）,阿司匹林敏感组（196例）,阿司匹林完全抑制组（148例）。检测并比较各组血脂、血糖、糖化血红蛋白、血清胱抑素C（cystatin C）、肾功能等指标。结果老年男性心血管病患者中,阿司匹林抵抗、阿司匹林敏感和阿司匹林完全抑制的发生率分别为为6.01%、53.55%和40.43%。与阿司匹林完全抑制组比较,阿司匹林抵抗组糖尿病患病率高,差异有统计学意义（P〈0.05）。多因素Logistic回归分析显示糖尿病和cystatin C与阿司匹林抵抗相关（P〈0.05）;在糖尿病患者中,多因素Logistic回归分析显示糖化血红蛋白与阿司匹林抵抗相关（P〈0.05）。结论少数老年男性心血管病患者存在阿司匹林抵抗,糖尿病和cystatin C是阿司匹林抵抗的危险因素;合并糖尿病的患者中,糖化血红蛋白是阿司匹林抵抗的危险因素。

Evaluation of risk factors for aspirin resistance in elderly male patients with cardiovascular diseases

Objective To assess the incidence of aspirin resistance and evaluate risk factors for aspirin resistance in elderly male patients with cardiovascular diseases. Methods 366 elderly male patients with cardiovascular diseases receiving daily aspirin therapy（100 mg /d） over one month were enrolled. According to the function of platelet aggregation detected by thrombelastography platelet mapping assay,366 patients were divided into three groups,aspirin-resistant groups（n =22）,aspirin-sensitive group（n =196） and aspirin-completely-inhibited group（n =148）. Results The incidence of aspirin-resistant,aspirin-sensitive and aspirin-completely-inhibited was 6. 01%,53. 55% and 40. 43% respectively.Compared with aspirin-completely-inhibited patients,there were more diabetes mellitus patients in the aspirin-resistant group（P〈0. 05）. Logistic regression analysis suggested that diabetes mellitus and cystatin C level were associated with aspirin resistance. HbA1 c was associated with aspirin resistance in patients with diabetes mellitus. Conclusions A small number of elderly male patients with cardiovascular diseases were aspirin-resistant. Diabetes mellitus and cystatin C levels are risk factors for aspirin resistance. HbA1 c is a risk factor for aspirin resistance in patients with diabetes mellitus.