老年冠心病介入治疗氯吡格雷抵抗的影响因素

王苏; 程宇彤; 王茜; 赵秀清; 张冬花; 阙斌; 李志忠

老年冠心病介入治疗氯吡格雷抵抗的影响因素

Prevalence and risk factors of clopidogrel resistance after percutaneous coronary intervention in patients over 60 years of age

摘要

摘要: 目的: 探讨60岁以上老年冠心病患者行冠状动脉介入治疗（percutaneous coronary intervention,PCI）术后氯吡格雷抵抗的发生率和影响因素。方法: 符合入选标准的患者208例，年龄61～80岁，根据对氯吡格雷的反应分为氯吡格雷抵抗组55例和氯吡格雷有反应组153例。结果: 氯吡格雷抵抗的发生率26.4%。氯吡格雷抵抗组和有反应组血小板聚集率(platelet aggregation rate,PAR)分别为（57±6）%和（35±9）%（P<0.01）。多因素logistic回归分析提示Ⅱ型糖尿病［P=0.037, 优势比（OR）=2.053，95%置信区间1.045-4.034］是氯吡格雷抵抗的影响因素。结论: 60岁以上老年冠心病患者PCI术后氯吡格雷抵抗的发生率26.4%，Ⅱ型糖尿病是氯吡格雷抵抗的影响因素。

Abstract: AIM: To assess the incidence and risk factors of clopidogrel resistance after percutaneous coronary intervention (PCI) with drug-eluting stent in patients >60 years of age. METHODS: The clinical data of 208 patients were collected, among whom 55 patients whose PAR >50% after PCI were assigned to the clopidogrel resistance group and the other 153 patients were assigned to the without resistance group. Correlation factors were analyzed and compared between groups. RESULTS: The incidence of clopidogrel resistance was 26.4% in elderly patients. The level of PAR was (57±6)% vs. (35±9)% (P<0.01) between the two groups after PCI. Multivariate logistic regression models found that the risk factor was diabetes mellitus (P=0.037, OR 2.053, 95% CI 1.045-4.034). CONCLUSION: The incidence of clopidogrel resistance is 26.4% after PCI with drug-eluting stent in patients >60 years of age, and diabetes mellitus is the risk factor for clopidogrel resistance.

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