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目的探讨合并糖尿病(DM)和冠状动脉粥样硬化性心脏病(CHD)患者发生阿司匹林或氯吡格雷抵抗的相关影响因素。方法将250例CHD患者按合并DM与否分为非DM组126例和DM组124例。收集患者一般资料,并进行1年随访,比较两组患者主要不良心血管事件(MACE),并分析MACE发生相关影响因素。结果 DM组较非DM组阿司匹林抵抗(AR)及氯吡格雷抵抗(CR)发生率均明显升高(P<0.05);DM组无抵抗、半抵抗、抵抗患者高敏C-反应蛋白(hs-CRP)、肌酸激酶同工酶(CK-MB)、三酰甘油(TG)等指标比较差异有统计学意义(P<0.05);Logistic分析显示,男性、心率、体质量指数(BMI)、TG、LDL-C、AR和CR是MACE发生独立危险因素。结论 CHD患者合并DM可促进阿司匹林抵抗或氯吡格雷抵抗,与患者心率、BMI、TG、LDL等指标相关,且药物抵抗易引起MACE发生。
Objective To explore the influencing factors of aspirin or clopidogrel resistance in patients with diabetes mellitus (DM) and coronary atherosclerotic heart disease (CHD). Methods 250 CHD patients were divided into non-DM group and non-DM group 126 cases and DM group 124 cases. The general data of patients were collected and followed up for one year. The main adverse cardiovascular events (MACE) were compared between the two groups and the related factors of MACE were analyzed. Results The incidence of aspirin (AR) and clopidogrel (CR) in DM group was significantly higher than that in non-DM group (P <0.05). In DM group, there was no resistance and no effect on the response to hs- CRP, CK-MB and triglyceride (TG) were significantly different (P <0.05). Logistic analysis showed that male, heart rate, body mass index TG, LDL-C, AR and CR are independent risk factors for MACE. Conclusions DM with DM can promote aspirin resistance or clopidogrel resistance, which is related to heart rate, BMI, TG, LDL and other indicators, and drug resistance can cause MACE.