2019 年第 11 期 第 14 卷

急性冠状动脉综合征患者阿司匹林抵抗的危险因素分析

Risk factors of aspirin resistance in patients with acute coronary syndrome

作者：赵宏磊白涛薛金熔刘永民孙立忠

英文作者：

单位：100029首都医科大学附属北京安贞医院心脏外科

英文单位：

关键词：急性冠状动脉综合征；阿司匹林抵抗；危险因素

英文关键词：

• 摘要：

• 【摘要】目的    探讨急性冠状动脉综合征（ACS）患者发生阿司匹林抵抗（AR）的危险因素。方法    选择首都医科大学附属北京安贞医院2015年10月至2018年10月收治的ACS患者341例，根据血小板功能检测结果，将患者分为阿司匹林敏感（AS）组（血小板聚集率≤20%）309例，AR组（血小板聚集率＞20%）32例。比较2组患者的基线资料、用药情况和实验室指标（肌酐清除率、血尿酸、空腹血糖、三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和血小板计数）水平，分析AR的危险因素。结果    341例ACS患者AR的发生率为9.4%（32/341）。AR组2型糖尿病史、吸烟史比例和空腹血糖水平均高于AS组［62.5%(20/32)比30.7%（95/309）、71.9%（23/32）比53.4%（165/309）、6.3(5.2,10.0)mmol/L比5.6(5.0,6.8)mmol/L］，差异均有统计学意义（均P＜0.05）。Logistic多因素回归分析结果显示,2型糖尿病史和吸烟史为发生AR的独立危险因素（回归系数=1.422、0.956，比值比=4.417、2.602,95%置信区间：1.924～9.941、1.142～5.930，P＜0.001、P=0.023）。结论    2型糖尿病史和吸烟史均为ACS患者发生AR的独立危险因素。

• 【Abstract】Objective    To explore the risk factors of aspirin resistance（AR） in patients with acute coronary syndrome（ACS）. Methods    Totally 341 patients with ACS were enrolled in Beijing Anzhen Hospital, Capital Medical University from October 2015 to October 2018. According to platelet function testing results, the patients were divided into aspirin sensitive(AS) group（platelet aggregation rate≤20%, 309 cases） and AR group（platelet aggregation rate＞20%， 32 cases）. Basic information, drug use, laboratory indicators（creatinine clearance rate, serum uric acid, fasting blood glucose, triglyceride, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and platelet count） were recorded to analyze the risk factors of AR. Results    Incidence of AR was 9.4%（32/341）. In AR group there were more patients with type 2 diabetes history and smoking history and higher fasting blood glucose level as compared with AS group［62.5%(20/32) vs 30.7%（95/309）, 71.9%（23/32） vs 53.4%（165/309）, 6.3(5.2,10.0)mmol/L vs 5.6(5.0,6.8)mmol/L］（all P＜0.05）. Multivariate logistic regression showed that type 2 diabetes history and smoking history were independent risk factors of AR(regression coefficient=1.422, 0.956; odds ratio=4.417, 2.602; 95% confidence interval: 1.924-9.941, 1.142-5.930; P＜0.001, P=0.023). Conclusion    Type 2 diabetes history and smoking history are independent risk factors of AR in patients with ACS.