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[目的]分析冠心病(coronary heart disease,CHD)患者二磷酸腺苷(adenosine diphosphate,ADP)和花生四烯酸(arachidonic acid,AA)诱导的最大血小板聚集率(maximum platelet agglutination rate,MPAR),评价CHD患者阿司匹林抵抗的危险因素及其与随访1年的主要不良心血管事件(Major Adverse Cardiovascular Events,MACE)的关系。[方法]203名住院患者检测ADP及AA诱导的MPAR,记录患者合并的心血管疾病危险因素、伴随临床疾病、超声心动图、冠状动脉造影结果及介入治疗措施。记录随访1年的MACE。所有数据采用Excel软件建库,SPSS11.5统计软件进行分析。[结果]203名患者中,冠状动脉造影(CAG)正常组16例(7.9%),稳定性心绞痛(SAP)组22例(10.8%),不稳定性心绞痛(UAP)组115例(56.7%),急性心肌梗死(AMI)组50例(24.6%)。各组AR的发生率分别为12.5%、36.4%、49.6%和66.0%,差异有统计学意义(P=0.001)。AR组hs-CRP、LDL-C水平及糖尿病患病率明显高于阿司匹林敏感(aspirin saitivity,AS)组。随访1年55例(27.1%)患者发生MACE,AR与AS组MACE发生无统计学差异(P=0.449)。[结论]冠心病患者AR与疾病的严重程度相关,hs-CRP、LDL-C水平升高及临床合并糖尿病是AR的危险因素,AR与患者1年MACE的发生无关。
[Objective] To analyze the maximum platelet agglutination rate (MPAR) induced by adenosine diphosphate (ADP) and arachidonic acid (AA) in patients with coronary heart disease (CHD) To evaluate the risk factors for aspirin resistance in patients with CHD and their relationship to major adverse cardiovascular events (MACE) at follow-up of 1 year. [Methods] 203 hospitalized patients were examined ADP and AA-induced MPAR, recorded in patients with cardiovascular disease risk factors, with clinical disease, echocardiography, coronary angiography and intervention measures. Record the follow-up of 1 year MACE. All data using Excel software building database, SPSS11.5 statistical software for analysis. [Results] Among the 203 patients, 16 (7.9%) were in the normal coronary angiography (CAG) group, 22 (10.8%) in the stable angina pectoris group (SAP) and 115 (56.7%) in the unstable angina pectoris group ), Acute myocardial infarction (AMI) group of 50 patients (24.6%). The incidence of AR in each group was 12.5%, 36.4%, 49.6% and 66.0%, respectively, with significant difference (P = 0.001). The levels of hs-CRP, LDL-C and the prevalence of diabetes in AR group were significantly higher than those in aspirin sa sensitivity (AS) group. MACE was found in 55 cases (27.1%) of patients who were followed up for one year. There was no significant difference in MACE between AR and AS (P = 0.449). [Conclusion] The AR of patients with coronary heart disease is related to the severity of the disease. The levels of hs-CRP and LDL-C are elevated and the clinical co-morbid diabetes is the risk factor of AR. AR has nothing to do with the one-year MACE.