冠心病患者阿司匹林抵抗与复发心血管事件的发生及相关危险因素分析

【目的】探讨冠心病患者阿司匹林抵抗(AR)与复发心血管事件的发生及相关危险因素。【方法】选取本院收治的冠心病住院患者270例作为研究对象,采用血栓弹力图分析其 AR 情况,270例中76例有 AR 者作为AR 组,194例对阿司匹林敏感者作为动脉粥样硬化(AS)组,对比两组心血管事件发生率,分析 AR 与心血管事件的关系。【结果】AR 组出现心血管事件的几率为39.47%(30/76),显著高于 AS 组的12.37%(24/194),且两组相比较差异有显著性(P <0.05)；270例患者中54例复发心血管事件的患者作为复发组,216例未复发心血管事件者作为未复发组,复发组高血压、糖尿病、吸烟、饮酒、抗血小板用药依从性差、AR 发生率显著高于未复发组,年龄、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)显著高于未复发组,高密度脂蛋白胆固醇(HDL-C)显著低于未复发组,且两组相比较差异均具有显著性(P <0.05)；多因素 Logistic 回归分析显示 AR、抗血小板用药依从性差、糖尿病、年龄是冠心病患者复发心脑血管事件的独立危险因素,其中 AR 与复发心脑血管事件呈正相关关系。【结论】AR 会增加冠心病患者复发心脑血管事件的几率。

Analysis of the Related Risk Factors of Aspirin Resistance and Recurrent Cardiovascular Events in Patients with Coronary Heart Disease

Objective]To investigate the related risk factors of aspirin resistance (AR)and recurrent cardio-vascular events in patients with coronary heart disease (CHD).Methods]The 270 inpatients with CHD treated in the hospital were selected as the research objects.100mg/d aspirin was administered after breakfast.The continu-ous administration lasted for 10 days.Then,intravenous blood sampling was performed.Adenosine diphosphate (ADP)was used as the inducer of platelet aggregation.Thrombelastogram was used to analyze aspirin resistance. 76 cases of patients with aspirin resistance were taken as AR group and 1 94 patients with aspirin sensitivity were taken as AS group.The incidence rates of cardiovascular events were compared between the two groups and the re-lationship between aspirin resistance and cardiovascular events was analyzed.Results]The incidence of cardiovas-cular events in AR group (39.47%)was significantly higher than that in AS group (12.37%)(P <0.05).Among the 270 patients in this group,54 patients with recurrent cardiovascular events were taken as the recurrence group and 21 6 cases without recurrent cardiovascular events were taken as the non-recurrence group.In the recurrence group,the incidence rates of hypertension,diabetes,smoking,drinking,poor anti-platelet drug compliance and AR were significantly higher than those in the non-recurrence group.Age,TC,TG and LDL-C were significantly higher than those in the non-recurrence group,while HDL-C was significantly lower in the recurrence group (P<0.05).Multivariate Logistic regression analysis showed that AR,poor anti-platelet drug compliance,diabetes and age were independent risk factors of cardiovascular events in patients with coronary heart disease,and AR cor-related positively with the recurrence of cardiovascular events.Conclusion]AR can increase the probability of re-current cardiovascular events in patients with coronary heart disease.