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目的评价老年心血管病患者阿司匹林抵抗的发生率及可能的潜在危险因素。方法选择老年心血管病患者454例,分为阿司匹林抵抗组111例,阿司匹林敏感组343例。口服阿司匹林(≥75 mg)>1个月,采用血栓弹力图法进行血小板聚集功能检测。结果与阿司匹林敏感组比较,阿司匹林抵抗组女性患者较多,P选择素、空腹血糖、TG、LDL-C明显增高,服用硝酸酯类药物的比例明显降低,差异有统计学意义(P<0.05,P<0.01)。多因素logistic回归分析显示,空腹血糖(OR=1.211.95%CI:1.047～1.402,P=0.010)、P选择素(OR=1.010,95%CI:1.002～1.01 9,P=0.019),服用硝酸酯类药物(OR=0.524,95%CI:0.309～0.890,P=0.017)与阿司匹林抵抗相关。结论老年心血管病患者阿司匹林抵抗发生率较高,空腹血糖、P选择素为阿司匹林抵抗的危险因素,硝酸酯药物为其保护性因素。
Objective To evaluate the incidence and possible risk factors of aspirin resistance in elderly patients with cardiovascular disease. Methods 454 elderly patients with cardiovascular disease were selected, divided into aspirin resistance group 111 cases, aspirin sensitive group 343 cases. Aspirin (≥75 mg) was given orally for more than 1 month, and platelet aggregation was measured by thrombi elastography. Results Compared with the aspirin sensitive group, there were more female patients in the aspirin resistance group, the P-selectin, fasting blood glucose, TG, LDL-C were significantly increased, the proportion of taking nitrates was significantly lower, the difference was statistically significant (P < P <0.01). Multivariate logistic regression analysis showed that fasting blood glucose (OR = 1.211.95% CI: 1.047-1.402, P = 0.010), P selectin (OR = 1.010, 95% CI: 1.002-1.01 9, P = 0.019) Nitrate drugs (OR = 0.524, 95% CI: 0.309-0.890, P = 0.017) were associated with aspirin resistance. Conclusion The incidence of aspirin resistance in elderly patients with cardiovascular disease is higher. Fasting blood glucose and P-selectin are the risk factors of aspirin resistance. Nitrate drugs are protective factors.