2型糖尿病对原发性高血压患者阿司匹林抵抗的临床影响(1)
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[摘要] 目的:探讨2型糖尿病对原发性高血压患者阿司匹林抵抗(AR)的临床影响。方法:选择诊断为原发性高血压患者96例,将其中患2型糖尿病患者38例设为观察组,将无糖尿病患者58例设为对照组,两组均服用阿司匹林100 mg/d,共服用4周,治疗后检测血小板聚集率,对检查情况进行统计分析。结果:观察组与对照组治疗4周后比较,在阿司匹林半抵抗 (ASR)发生方面,差异具有统计学意义(P<0.05);AR+ASR发生方面,差异具有统计学意义(P<0.01)。结论:2型糖尿病与阿司匹林抵抗的发生具有明显的相关性,提示合并2型糖尿病的原发性高血压患者会有较高的血栓性疾病发生可能,临床应给予充分重视。
[关键词] 2型糖尿病;原发性高血压;阿司匹林抵抗
[中图分类号] R587.1 [文献标识码]A [文章编号]1674-4721(2010)06(a)-020-02
Clinical implications of aspirin resistance about type 2 diabetes patients with essential hypertension
GU Haiwei,LU Jie,JIANG Kemin
(Department of Geriatric,Central Hospital of Minhang District in Shanghai City, Shanghai 201100,China)
[Abstract] Objective:To discuss the clinical implications of aspirin resistance about type 2 diabetes patients with essential hypertension. Methods: 96 patients with essential hypertension were collected, 38 patients with type 2 diabetes were divided into observer group,58 patients without type 2 diabetes were divided into control group,all patients took aspirin 100 mg/d, for 4 weeks, tested platelet aggregation after treatment, statistics and analyzed the results.Results: After 4 weeks' treatment, compared the occurrence of ASR,there was a significant statistical significance(P<0.05); compared the occurrence of AR+ASR, there was a significant statistical significance(P<0.01).Conclusion: Type 2 diabetes and the incidence of aspirin resistance has obvious relevance, essential hypertension patients with type 2 diabetes have a higher thrombotic disease, clinical attention should be given full.
[Key words] Type 2 diabetes;Essential hypertension;Aspirin resistance
临床试验证明,阿司匹林作为一种有效的抗血小板聚集药物,在预防心脑血管急性血栓栓塞性疾病方面起着重要的作用[1]。心脑血管疾病在2型糖尿病患者中发病率明显高于正常人群,是2型糖尿病致残、致死的主要原因,约占全部死因的70%左右[2]。这可能与血小板的异常活化、内皮损伤及炎症反应有关。阿司匹林(aspirin)是目前应用最广泛的预防血栓形成的药物之一,其主要通过不可逆的抑制血小板环氧化酶(cyclooxygenase,COX)而抑制血小板的聚集功能。但阿司匹林的抗血小板作用在人群中的反应并不一致,在口服常规剂量阿司匹林的患者中,部分患者仍发生血栓栓塞事件。针对这种现象,有学者提出“阿司匹林抵抗(aspirinresistance,AR)”概念[3]。笔者通过血小板聚集率的检测,探讨2型糖尿病对原发性高血压患者阿司匹林抵抗的临床影响情况,现报道如下:
1 资料与方法
1.1一般资料
收集本科2008年11月～2009年9月,门诊患者中诊断为原发性高血压96例,诊断标准符合1999年WHO/ISH制订的高血压病诊断标准,血压稳定控制在150/90 mmHg以下,其中,男53例,女43例,年龄52～73岁,平均65.7岁。其中38例患者同时患有糖尿病,糖尿病诊断标准符合1999年WHO推荐的糖尿病诊断标准[4],男23例,女15例,年龄56～72岁,平均68 ......
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