抗血小板药物抵抗对急性心肌梗死患者再发心脏缺血事件的预测价值

被引：15

作者：

李蕾 ^{[1
]}

韩江莉 ^{[1
]}

李海燕 ^{[1
]}

乔蕊 ^{[2
]}

于海奕 ^{[1
]}

曾辉 ^{[1
]}

高炜 ^{[1
]}

张捷 ^{[2
]}

机构：

[1] 北京大学第三医院心内科卫生部心血管分子生物学与调节肽重点实验室及分子心血管学教育部重点实验室

[2] 北京大学第三医院检验科

来源：

中华医学杂志 | 2012年 / 38期

关键词：

心肌梗死; 抗药性; 氯吡格雷; 阿司匹林;

D O I：

暂无

中图分类号：

R541.4 [冠状动脉（粥样）硬化性心脏病（冠心病）];

学科分类号：

1002 ; 100201 ;

摘要：

目的评估抗血小板药物抵抗对再发心脏缺血事件的预测价值。方法用全血电阻法(EIA)检测急性心肌梗死(AMI)患者109例,观察阿司匹林和氯吡格雷对AMI患者血小板聚集的抑制程度,分为单纯阿司匹林抵抗组(AR)、单纯氯吡格雷抵抗组(CR)、双抵抗组(DR)和双敏感组(DS)。随访记录再发心脏缺血事件。结果 AR组16例,CR组10例,DR组4例,DS组79例。AR组血小板计数和血糖高于DS组[(221±52)×10～9/L比(201±35)×10～9/L;(6.8±2.6)mmol/L比(5.8±1.9)mmol/L,P<0.05];AR、CR和DR组心脏缺血事件显著高于DS组(12.5%,10.0%,50.0%比3.8%,P=0.036),其中支架内血栓发生率为6.3%,10.0%,50.0%比1.3%,(P=0.000)。多因素分析示双抵抗是AMI患者支架术后1年心脏缺血事件和支架内血栓的独立预测因素(OR5.99,95%CI 1.05～34.34,P=0.045;OR 6.36,95%CI 1.13～35.78;P=0.036)。结论抗血小板药物抵抗与AMI患者临床预后密切相关,阿司匹林联合氯吡格雷抵抗是再发心脏缺血事件的独立预测因素。

引用

页码：2677 / 2680

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