服用小剂量阿司匹林对于冠心病患者的阿司匹林抵抗

目的探讨服用小剂量阿司匹林冠心病患者的阿司匹林抵抗（AR）现象及其相关因素。方法经冠脉造影确诊为冠心病患者137例，服用阿司匹林100mg／d≥1周后，分别用花生四烯酸（AA）、二磷酸腺苷（ADP）作诱导剂检测血小板聚集率。满足AA诱导的血小板平均聚集率≥20％、ADP诱导的血小板平均聚集率≥70％两项者为AR；仅满足其中一项为阿司匹林半抵抗（ASR）；均不满足者为阿司匹林敏感（脶）。结果137例患者中AR发生率为22．63％（31例），ASR发生率为17．52％（24例），AR＋ASR发生率为40．16％（55例）．AS发生率为59．85％（82例）。AR＋ASR组中的糖尿病、不稳定型心绞痛患者均较As组多（P〈0．05）；AR＋ASR组患者血浆总胆固醇浓度显著高于AS组（P〈0．05），血浆低密度脂蛋白-胆固醇浓度有高于AS组倾向（P〉0．053）。结论服用小剂量阿司匹林的冠心病患者AR＋ASR发生率为40．16％；AR或ASR者血浆胆固醇浓度较高；精尿病、不稳定型心绞痛患者AR或ASR发生率较高。

Study on aspirin resistance(AR)in coronary heart disease(CHD) patients taking small dose of aspirin

Objective To investigate the phenomenon and influencing factors d AR in CHD patients taking small dose of aspirin. Methods 37 CHD patients diagnosed by coronary after） angiogram took aspirin 100 mg/d for ≥7days, and then their blood samples were collected for determination of optical platelet aggregation index using arachidonic acid （AA） and adenosine diphosphate （ADP）. AR was defined as a state in which aggregation of ≥ 20% with AA and that ≥70% with ADP was fannd. Aspirin semiresistance （ASR） was defined as meeting one of the above criteria. If both above criteria were not met, the condition was defined as aspirin sensitive（AS） .The difference in clinical characteristics among the groups were analyzed. Results Of 137 CHD patients, 22.63% were AR, 17.52% were ASR. Among AR ＋ ASR group, diabetic, unstable angina patients were predominant（ P 〈 0.05）. The plasma level of total choleterol in AR ＋ ASR group was higher than that in AS group（5.04 ± 1.28 vs 4.59 ± 0.88, P 〈 0.05）. Conclusions The incidence rate of AR ＋ ASR among CHD patients taking small dose of aspirin is 40.16%. The plasma level of total choleterol in AR ＋ ASR group is higher than that in AS group. The incidence tale of AR ＋ ASR in diabetes mellitus and unstable angina patients increases.