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老年2型糖尿病患者阿司匹林抵抗的发生率及相关危险因素分析

Prevalence and risk factors for aspirin resistance in elderly patients with type 2 diabetes

摘要:

目的 评价老年2型糖尿病患者阿司匹林抵抗的发生率及可能的危险因素.方法 140例老年2型糖尿病患者,年龄60~92岁,平均(73.8±8.0)岁,口服阿司匹林(≥75 mg)1个月以上.血小板聚集功能采用血小板聚集试验(LTA)和血栓弹力图法(TEG)评价.结果 LTA法检测6例(4.3%)患者为阿司匹林抵抗,44例(31.4%)患者为阿司匹林半抵抗.TEG法检测31例(22.1%)患者为阿司匹林抵抗,其中LTA法显示3例.经TEG法检测分组多因素回归分析结果显示,女性(OR=5.54,95%CI:1.17~27.47,P=0.036)、同型半胱氨酸水平(OR=1.15,95%CI:1.00~1.35,P=0.043)为阿司匹林抵抗的危险因素.结论 老年2型糖尿病患者阿司匹林抵抗发生率较高,阿司匹林抵抗更易发生在女性、高同型半胱氨酸水平的患者.

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Objective Although aspirin resistance has been recognized to occur in patients with diabetes mellitus, the prevalence and related risk factors for aspirin resistance in elderly patients with diabetes mellitus have not been reported yet. The purpose of the present study was to evaluate the prevalence and potential risk factors for aspirin resistance in elderly patients with type 2 diabetes.Methods The 140 elderly patients [aged from 60 to 92 years, mean age (73.8±8. 0) years] with type 2 diabetes receiving daily aspirin therapy (≥ 75 mg) over one month were recruited. Platelet aggregation was measured by light transmittance aggregometry (LTA) and thrombelastograph (TEG)platelet mapping assay. Results By LTA, 6 patients (4.3%) of the diabetic patients were found to be resistant to aspirin therapy, 44 patients (31.4 %) were semi-responders. By TEG, 31 patients (22. 1%) were aspirin resistant. Among the 31 patients who were aspirin resistant by TEG, 3 were aspirin resistant by LTA. In the multivariate logistic regression analysis, female gender (OR= 5. 54,95%CI: 1.17-27.47, P=0.036) and homocysteine level (OR=1.15, 95%CI: 1.00-1.35, P=0. 043) were statistically significant risk factors for aspirin resistance by TEG. Conclusions The prevalence of aspirin resistance in elderly patients with type 2 diabetes is considerably higher in elderly female patients and in elderly patients with higher serum homocysteine level.

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