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目的观察老年2型糖尿病合并冠心病患者发生氯吡格雷抵抗的情况,探讨分析相应的危险因素。方法选择本院2011年7月—2013年7月期间收治的76例老年2型糖尿病合并冠心病患者作为观察对象,根据血小板聚集试验结果进行分组,其中血小板抑制率>50%共40例(对照组),<50%共36例(观察组),对比2组流行病学、脂代谢、糖代谢与超敏C反应蛋白等水平值。结果 2组患者年龄、性别、体重、高脂血症与高血压发病史以及吸烟史等流行病学指标对比,差异均不具有统计学意义(均P>0.05);观察组空腹血糖、超敏C反应蛋白显著高于对照组,而高密度脂蛋白胆固醇显著低于对照组,差异均具有统计学意义(均P<0.05);经多因素分析后,高密度脂蛋白胆固醇、空腹血糖、超敏C反应蛋白均是影响患者发生氯吡格雷抵抗的危险因素(均P<0.05)。结论老年2型糖尿病合并冠心病患者出现氯吡格雷抵抗的发生率大,且与患者的空腹血糖水平、高密度脂蛋白胆固醇、超敏C反应蛋白等因素有关,值得临床上进一步分析。
Objective To investigate the incidence of clopidogrel resistance in elderly type 2 diabetic patients with coronary heart disease and to explore the corresponding risk factors. Methods A total of 76 elderly patients with type 2 diabetes mellitus and coronary heart disease admitted from July 2011 to July 2013 in our hospital were selected as the observation subjects. According to the results of platelet aggregation test, 40 patients with platelet inhibition rate> 50% (control Group), <50% in 36 cases (observation group), and compared the epidemiology, lipid metabolism, glucose metabolism and high sensitivity C-reactive protein in two groups. Results There was no significant difference in the epidemiological indexes such as age, gender, body weight, history of hyperlipidemia and hypertension and smoking history between the two groups (all P> 0.05). The fasting blood glucose, hypersensitivity C-reactive protein was significantly higher than that of the control group, while high density lipoprotein cholesterol was significantly lower than the control group, the differences were statistically significant (all P <0.05); after multivariate analysis, high-density lipoprotein cholesterol, fasting blood glucose, Sensitive C-reactive protein are risk factors affecting the occurrence of clopidogrel resistance in patients (all P <0.05). Conclusions The incidence of Clopidogrel resistance in elderly patients with type 2 diabetes mellitus complicated by coronary heart disease is large and related to such factors as fasting blood glucose level, high density lipoprotein cholesterol, high-sensitivity C-reactive protein and other factors and deserves further clinical analysis.