糖尿病状态下阿司匹林抵抗的研究进展

阿司匹林作为抗血小板聚集治疗的“金标准”，在预防心脑血管栓塞性疾病方面起着重要的作用。然而在服用阿司匹林后，并非所有的患者均能获得一致的抗血小板聚集效益。临床上，服用治疗剂量的阿司匹林后仍出现心血管事件的现象被称为“阿司匹林抵抗（aspirinresistance，AR）”。发生阿司匹林抵抗的患者中有相当一部分是糖尿病患者。尽管很多糖尿病患者服用阿司匹林进行心血管疾病的一级预防，但获益很低。对于非糖尿病患者，阿司匹林可以降低41％的心血管事件。而在糖尿病患者中心血管事件发生率仅降低了10％。虽然研究显示糖尿病同阿司匹林抵抗高度相关，然而糖尿病患者中高阿司匹林抵抗发生率的原因还不清楚。本文拟就糖尿病患者的阿司匹林抵抗机制及其逆转方法进行探讨。

Research progress of aspirin resistance in diabetic statue

Aspirin is the ＂gold standard＂ of antiplatelet therapy. It plays a very important role in the prevention of cardiovascular disease. However, not all the patients can respond a con sistent anti-aggregation effect after they take as pirin. Clinically, this phenomenon that thera peutic dose of aspirin can not prevent the cardio vascular events is called ＂ aspirin resistance （AR）＂. A considerable portion of aspirin resist ance patients also have diabetes or insulin resist- ance. Many diabetic patients take aspirin for pri mary prevention of cardiovascular disease, but the benefit is low. Aspirin can reduce the risk ofcardiovascular events by 41~ in non-diabetic pa tients. But the risk reduction in the subgroup with diabetes was only 10~//00. Although diabetes has been recognised as a high risk factor of aspi rin resistance, the mechanism under the high di abetic prevalence in aspirin resistance patients is unclear. This paper will review the mechanisms of aspirin resistance in diabetic statue and ex plore methods to reverse it.