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目的研究老年T2DM合并冠心病患者对阿司匹林的反应性及其危险因素。方法选择我院老年科住院的T2DM合并冠心病患者147例,根据血栓弹力图(TEG)结果将其分为阿司匹林抵抗组(AR,抑制率≤50%)和阿司匹林非抵抗组(N-AR),并分析两组临床数据。结果 AR组30例,NAR组117例。AR发生率为20%。AR组同型半胱氨酸(Hcy)、FPG、TG、LDL-C及HbA1c分别为(16.43±4.77)mmol/L,(7.73±0.16)mmol/L,(1.70±0.60)mmol/L,(2.60±0.55)mmol/L,(7.79±0.58)%,均明显高于N-AR组,而视黄醇结合蛋白(RBP)为(34.17±9.30)mmol/L,低于NAR组(P<0.05)。Logistic回归分析结果显示,FPG、TC、LDL-C和Hcy是AR的影响因素,使患者AR的危险性分别提高1.9倍,0.1倍,13.1倍和1.1倍。血糖不达标者、糖尿病病程较长者AR发生率增高(P<0.05)。结论 T2DM合并冠心病患者存在一定的AR现象,有效地控制血糖,减低血脂,降低Hcy,可降低AR发生率。
Objective To study the reactivity and risk factors of aspirin in elderly T2DM patients with coronary heart disease. Methods A total of 147 T2DM patients with coronary heart disease admitted to our hospital were divided into aspirin resistance group (AR, ≤50% inhibition rate) and aspirin non-resistance group (N-AR) according to the results of TEG. , And analyzed two sets of clinical data. Results There were 30 cases in AR group and 117 cases in NAR group. The incidence of AR was 20%. The levels of homocysteine, FPG, TG, LDL-C and HbA1c in AR group were (16.43 ± 4.77) mmol / L, (7.73 ± 0.16) mmol / L and 2.70 ± 0.55 mmol / L and 7.79 ± 0.58% respectively, which were significantly higher than those in N-AR group and retinol binding protein (RBP) was (34.17 ± 9.30) mmol / L, 0.05). Logistic regression analysis showed that FPG, TC, LDL-C and Hcy were the influencing factors of AR, which increased the risk of AR by 1.9 times, 0.1 times, 13.1 times and 1.1 times respectively. Those who did not meet the standard of glycemic control had a higher incidence of AR (P <0.05). Conclusion There is a certain AR phenomenon in patients with T2DM complicated with coronary heart disease, which can effectively control blood sugar, reduce blood fat, reduce Hcy and reduce the incidence of AR.