冠心病合并高血压患者氯吡格雷抵抗危险因素的Logistic回归分析

目的探讨双联抗血小板治疗冠心病合并高血压患者氯吡格雷抵抗(CR)的危险因素。方法回顾性分析2010年10月-2011年4月入我院心内科,采取双联抗血小板治疗的122例冠心病合并高血压患者的临床资料。根据血小板抑制情况(mTEG中ADP途径的抑制率)将其分为氯吡格雷抵抗组(NRG)和反应组(RG)。对CR的可能危险因素进行单因素分析和多因素逐步Logistic回归分析。结果 122例中49例出现CR,发生率为40.2%;单因素分析3个变量影响患者对氯吡格雷的反应性;进一步Logistic回归分析发现:空腹血糖是该类患者发生CR的独立危险因素(β=0.193;P=0.033),不排除饮酒对CR的保护作用(β=-1.175;P=0.051)。结论空腹血糖与CR密切相关,冠心病合并高血压患者氯吡格雷治疗的同时应积极控制血糖。

Risk factors for clopidogrel resistance in patients with coronary artery disease accomapmying hypertension:A logistic regression analysis

Objective To study the risk factors for clopidogrel resistance(CR) in patients with coronary artery disease(CAD) accompanying hypertension(HPT).Methods Clinical data about 122 patients with CAD accompanying HPT admitted to Department of Cardiology,Chinese PLA General Hospital,from October 2010 to April 2011,were retrospectively analyzed.The patients were divided into CR group and clopidogrel response group according to the inhibition of their platelets(through the way of ADP inhibition rate in mTEG).The patients were divided into non-response group(NRG) and response group(RG).The risk factors for clopidogrel response were analyzed by univariate analysis and multivariate stepwise logistic regression analysis.Results Of the 122 patients with CAD accompanying HPT,49 were responsive to clopidogrel,accounting for 40.2%.Univariate analysis showed that 3 variables could influence the response of patients with CAD accompanying HPT to clopidogrel.Multivariate stepwise logistic regression analysis revealed that fasting blood glucose was an independent factor for CR in these patients(β=0.193,P=0.033) and alcohol drinking might be a protective factor for CR(β=-1.175,P=0.051).Conclusion Fasting blood glucose is closely related with CR and therefore it should actively controlled in patients with CAD accompanying HPT on clopidogrel therapy.