糖尿病患者经皮冠状动脉介入术后氯吡格雷抵抗的临床观察

目的:探讨Ⅱ型糖尿病患者经皮冠状动脉介入术后氯吡格雷抵抗现象。方法:入院急性冠脉综合征(ACS)患者46例,其中糖尿病患者11例,非糖尿病患者35例,予氯吡格雷负荷量300 mg,继予75 mg/d维持,在服用氯吡格雷前,服药后2、4、6、24、48与30 d取血,测定5μmol/L二磷酸腺苷(ADP)诱导的血小板聚集率,分析两组间临床特征、血小板抑制率的差异。结果:糖尿病患者11例中氯吡格雷抵抗的发生率为55%,高于非糖尿病患者26%(P0.05)。结论:在经PCI治疗的ACS并发Ⅱ型糖尿病患者中氯吡格雷抵抗的发生率高于非糖尿病患者。

Clinical observations of platelet aggregation in patients with type II diabetes undergoing percutaneous coronary intervention with clopidogrel treatment

AIM: To examine clopidogrel resistance among patients with type II diabetes undergoing percutaneous coronary intervention (PCI) on clopidogrel treatment. METHODS: Forty six patients (11 diabetic and 35 nondiabetic patients) with acute coronary syndrome (ACS) who had undergone PCI were treated with clopidogrel (300 mg loading dose followed by a dose of 75 mg/day). Platelet aggregation function was assessed before and 2, 4, 6, 24, 48 and 30 days after clopidogrel treatment. Platelet aggregation and characteristics between groups were compared. RESULTS: The ratio of clopidogrel resistance was much higher in diabetic patients (55%) than in nondiabetic patients (26%) (P<0.05). CONCLUSION: Diabetic subjects undergoing PCI have a higher ratio of clopidogrel resistance compared with nondiabetic subjects.