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|本期目录/Table of Contents|

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

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2010年第3期
页码:
390-392
栏目:
临床研究
出版日期:
2010-04-06

文章信息/Info

Title:
Clinical observations of platelet aggregation in patients with type II diabetes undergoing percutaneous coronary intervention with clopidogrel treatment
作者:
杨帆; 赖沙毅; 王红
广西医科大学第四附属医院柳州市工人医院心内科，广西 柳州 545005
Author(s):
YANG Fan;  LAI Sha-yi;  WANG Hong
Department of Cardiology, Fourth Affiliated Hospital, Guangxi Medical University, Liuzhou 545005, Guangxi, China
关键词:
糖尿病; 急性冠脉综合征; 氯吡格雷抵抗; 血小板聚集率
Keywords:
type II diabetes;  acute coronary syndrome;  clopidogrel resistance;  platelet aggregation
分类号:
R541.4
DOI:
-
文献标识码:
A
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.

参考文献/References

［1］Paul AG, Bliden KP, Hiatt BL, et al. Clopidogrel for coronary stenting: response variability, drug resistance, and the effect of pretreatment platelet reactivity［J］. Circulation, 2003, 107(23):2908-2913.

［2］Angiolillo DJ, Fernandez-Ortiz A, Bernardo E, et al. Platelet function profiles in patients with type 2 diabetes and coronary artery disease on combined aspirin and clopidogrel treatment ［J ］. Diabetes, 2005, 54(8):2430-2435.

［3］Lau WC, Gurbel PA, Watkins PB, et al. Contribution of hepatic cytochrome P450 3A4 metabolic activity to the phenomenon of clopidogrel resistance［J］. Circulation, 2004, 109(2):166-171.

［4］ Angiolillo DJ, Bernardo E, Ramírez C, et al. Insulin therapy is associated with platelet dysfunction in patients with type 2 diabetes mellitus on dual oral antiplatelet treatment［J］. J Am Coll Cardiol, 2006, 48(2):298-304.

［5］ Colwell JA, Nesto RW. The platelet in diabetes: focus on prevention of ischemic events［J］. Diabetes Care, 2003, 26(7):2181-2188..

［6］ Ferroni P, Basili S, Falco A, et al. Platelet activation in type 2 diabetes mellitus［J］. J Thromb Haemost, 2004, 2(8):1282-1291.

［7］Watala C, Golanski J, Pluta J, et al. Reduced sensitivity of platelets from type 2 diabetic patients to acetylsalicylic acid (aspirin): its relation to metabolic control［J］. Thromb Res, 2004, 113(2):101-113.

备注/Memo

备注/Memo:
收稿日期：2008-07-31.基金项目：广西壮族自治区卫生厅自筹经费科研课题资助(Z2006228) 作者简介：杨帆，博士生Email:wzyyfgh99820@yahoo.com.cn
更新日期/Last Update: 2010-04-09