糖尿病患者经皮冠状动脉介入术后氯吡格雷抵抗的临床观察

杨帆; 赖沙毅; 王红

糖尿病患者经皮冠状动脉介入术后氯吡格雷抵抗的临床观察

Clinical observations of platelet aggregation in patients with type II diabetes undergoing percutaneous coronary intervention with clopidogrel treatment

摘要

摘要: 目的: 探讨Ⅱ型糖尿病患者经皮冠状动脉介入术后氯吡格雷抵抗现象。方法: 入院急性冠脉综合征(ACS)患者46例，其中糖尿病患者11例，非糖尿病患者35例，予氯吡格雷负荷量300 mg，继予75 mg/d维持，在服用氯吡格雷前，服药后2、4、6、24、48与30 d取血，测定5 μmol/L二磷酸腺苷（ADP）诱导的血小板聚集率，分析两组间临床特征、血小板抑制率的差异。结果: 糖尿病患者11例中氯吡格雷抵抗的发生率为55%，高于非糖尿病患者26%(P<0.05)。结论: 在经PCI治疗的ACS并发Ⅱ型糖尿病患者中氯吡格雷抵抗的发生率高于非糖尿病患者。

Abstract: AIM: To examine clopidogrel resistance among patients with type II diabetes undergoing percutaneous coronary intervention (PCI) on clopidogrel treatment. METHODS: Forty six patients (11 diabetic and 35 nondiabetic patients) with acute coronary syndrome (ACS) who had undergone PCI were treated with clopidogrel (300 mg loading dose followed by a dose of 75 mg/day). Platelet aggregation function was assessed before and 2, 4, 6, 24, 48 and 30 days after clopidogrel treatment. Platelet aggregation and characteristics between groups were compared. RESULTS: The ratio of clopidogrel resistance was much higher in diabetic patients (55%) than in nondiabetic patients (26%) (P<0.05). CONCLUSION: Diabetic subjects undergoing PCI have a higher ratio of clopidogrel resistance compared with nondiabetic subjects.

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