2019 年第 2 期 第 14 卷

2型糖尿病患者发生氯吡格雷抵抗的危险因素分析

Risk factors of clopidogrel resistance in patients with type 2 diabetes mellitus

作者：李红梅刘俊伟

英文作者：

单位：510010广州军区广州总医院内分泌科

英文单位：

关键词：2型糖尿病；氯吡格雷抵抗；Logistic回归

英文关键词：

• 摘要：

• 【摘要】目的    分析2型糖尿病患者发生氯吡格雷抵抗的危险因素。方法    回顾性纳入2016年1月1日至2017年12月31日广州军区广州总医院住院2型糖尿病患者407例，均持续口服硫酸氢氯吡格雷75 mg/d至少7 d。通过测定二磷酸腺苷诱导的血小板聚集率，将患者分为氯吡格雷抵抗组（血小板聚集率＞50%）和非氯吡格雷抵抗组。详细记录患者的基本资料并进行单因素分析和Logistic回归分析。结果    56例患者（13.8%）发生氯吡格雷抵抗。单因素分析结果表明，氯吡格雷抵抗组吸烟者比例、体重指数、糖化血红蛋白和三酰甘油水平明显高于非氯吡格雷抵抗组，差异均有统计学意义（均P＜0.05）。将这4项因素纳入Logistic回归模型的分析，结果显示，糖化血红蛋白（比值比＝2.463，95%置信区间：0.912～6.651）和三酰甘油（比值比＝2.215，95%置信区间：1.032～3.432）是导致氯吡格雷抵抗发生的危险因素（均P＜0.05）。结论    高糖化血红蛋白水平及高三酰甘油水平是2型糖尿病患者发生氯吡格雷抵抗的高危风险因素。

• 【Abstract】Objective    To analyze the risk factors of clopidogrel resistance in patients with type 2 diabetes mellitus. Methods    Clinical data of 407 patients with type 2 diabetes mellitus admitted to General Hospital of Guangzhou Military Command of the Chinese People′s Liberation Army from January 1st, 2016 to December 31st, 2017 were prospectively analyzed. All patients had taken clopidogrel 75 mg daily for at least 7 days. Platelet aggregation rate induced by adenosine diphosphate was tested and clopidogrel resistance was defined as platelet aggregation rate＞50%. Risk factors of clopidogrel resistance were analyzed. Results    Clopidogrel resistance occurred in 56 patients（13.8%）. Smoking ratio, body mass index, glycosylated hemoglobin and triglyceride level in patients with clopidogrel resistance were significantly higher than those in patients without clopidogrel resistance（P＜0.05）. Logistic regression analysis showed that glycosylated hemoglobin（odds ratio＝2.463， 95% confidence interval： 0.912-6.651） and triglyceride（odds ratio＝2.215， 95% confidence interval： 1.032-3.432） were risk factors of clopidogrel resistance(both P＜0.05). Conclusion    High levels of glycosylated hemoglobin and triglyceride are risk factors of clopidogrel resistance in patients with type 2 diabetes mellitus.