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目的探讨代谢综合征患者阿司匹林抵抗的发生率和临床特征。方法对2005年5月至6月北京首钢社区人群中221例病情稳定的代谢综合征患者,口服阿司匹林200mg/d共10d后,应用血小板聚集仪测定花生四烯酸(AA)诱导的血小板聚集率。以0.5g/LAA诱导的血小板平均聚集率≥20%为阿司匹林抵抗。结果阿司匹林抵抗发生率为17.6%(39/221)。阿司匹林抵抗(AS)组患者的纤维蛋白原水平显著高于阿司匹林敏感(AR)组的患者[(2.6±0.4)g/L对(2.4±0.4)g/L,P=0.017)]。两组患者的血压、年龄、空腹血糖、血脂以及体重指数等差异均无统计学意义;性别、吸烟、既往心梗或脑梗病史的分布也无统计学意义。进一步根据患者性别进行分层分析发现,在男性患者中心梗病史是阿司匹林抵抗的预测因素(50%对14.5%,P=0.020),在女性患者中舒张压高于85mmHg(1mmHg=0.133kPa)是阿司匹林抵抗的预测因素(34.0%对15.5%,P=0.043)。结论研究人群中阿司匹林抵抗的发生率为17.6%,高纤维蛋白原是阿司匹林抵抗的危险因素,心梗病史和较高的舒张压可能分别是男性和女性阿司匹林抵抗的预测因素。
Objective To investigate the incidence and clinical characteristics of aspirin resistance in patients with metabolic syndrome. Methods A total of 221 stable metabolic syndrome patients from Beijing Shougang community from May to June in 2005 were randomly divided into two groups. After oral administration of aspirin 200 mg / d for 10 days, platelet aggregation was used to determine arachidonic acid (AA) -induced platelet aggregation . The average platelet aggregation rate ≥20% induced at 0.5g / LAA was aspirin resistance. Results The incidence of aspirin resistance was 17.6% (39/221). Fibrinogen levels in aspirin resistance (AS) patients were significantly higher than those in aspirin-sensitive (AR) patients (2.6 ± 0.4 vs 2.4 ± 0.4 g / L, P = 0.017). There were no significant differences in blood pressure, age, fasting blood glucose, blood lipids and body mass index between the two groups. The distribution of gender, smoking, previous myocardial infarction or cerebral infarction was also not statistically significant. Further stratification based on patient sex found that the history of MI in male patients was a predictor of aspirin resistance (50% vs. 14.5%, P = 0.020) and was more than 85 mmHg (1 mmHg = 0.133 kPa) in women Predictors of aspirin resistance (34.0% vs. 15.5%, P = 0.043). Conclusions The prevalence of aspirin resistance in the study population was 17.6%. High fibrinogen was a risk factor for aspirin resistance. A history of myocardial infarction and high diastolic blood pressure may be predictors of aspirin resistance in men and women, respectively.