2型糖尿病患者发生阿司匹林抵抗危险因素分析
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摘要
目的探讨2型糖尿病患者发生阿司匹林抵抗的相关因素。方法共纳入358例2型糖尿病住院患者,持续口服阿司匹林100 mg至少7 d,详细记录患者基本资料并进行单因素分析和Logistic回归分析。结果共67例(18. 72%)患者发生抵抗事件,单因素分析结果表明抵抗组中吸烟、女性、空腹血糖、糖化血红蛋白、低密度脂蛋白的构成比明显高于非抵抗组,差异有统计学意义(P <0. 05)。将单因素分析有统计学意义的5个因素放入Logistic回归模型,结果显示,糖化血红蛋白(OR=2. 599,95%CI=1. 093～5. 989)及低密度脂蛋白胆固醇水平(OR=2. 134,95%CI=0. 929～4. 902),差异有统计学意义(P <0. 05)。结论 2型糖尿病患者发生阿司匹林抵抗的高危因素是糖化血红蛋白及低密度脂蛋白水平升高。
Objective To investigate the risk factors of aspirin resistance in type 2 diabetes mellitus patients. Methods Prospectively enrolled 358 patients who have taken aspirin( 100 mg daily) at least 7 d.Factors which would likely influence the aspirin resistance were collected,those which showed statistical significance by One Way ANOVA analysis were screened and followed by further Logistic regression analysis to obtain the independent risk factors. Results Aspirin resistance was found in 67( 18. 72%) patients. The Logistic regression analysis finally showed 2 factors,glycated hemoglobin( OR = 2. 599,95% CI = 1. 093-5. 989) and low-density lipoprotein( OR = 2. 134,95% CI = 0. 929-4. 902) were the independent risk factors,out of 5 factors( smoker,female,fasting blood glucose,Hb A1 c and low-density lipoprotein) which showed statistical significance in One Way ANOVA analysis( P < 0. 05).Conclusion Aspirin resistance is associated with high level of glycated hemoglobin and low-density lipoprotein in type 2 diabetes mellitus patients.
Objective To investigate the risk factors of aspirin resistance in type 2 diabetes mellitus patients. Methods Prospectively enrolled 358 patients who have taken aspirin( 100 mg daily) at least 7 d.Factors which would likely influence the aspirin resistance were collected,those which showed statistical significance by One Way ANOVA analysis were screened and followed by further Logistic regression analysis to obtain the independent risk factors. Results Aspirin resistance was found in 67( 18. 72%) patients. The Logistic regression analysis finally showed 2 factors,glycated hemoglobin( OR = 2. 599,95% CI = 1. 093-5. 989) and low-density lipoprotein( OR = 2. 134,95% CI = 0. 929-4. 902) were the independent risk factors,out of 5 factors( smoker,female,fasting blood glucose,Hb A1 c and low-density lipoprotein) which showed statistical significance in One Way ANOVA analysis( P < 0. 05).Conclusion Aspirin resistance is associated with high level of glycated hemoglobin and low-density lipoprotein in type 2 diabetes mellitus patients.
引文
[1]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版)[J].中华糖尿病杂志,2018,10(1):4-67.
[2]OZBEN S,OZBEN B,TANRIKULU A M,et al.Aspirin resistance in patients with acute ischemic stroke[J].J Neurol,2011,258(11):1979-1986.
[3]CAI G,ZHOU W,LU Y.Aspirin resistance and other aspirin-related concerns[J].Neurol Sci,2016,37(2):181-189.
[4]FITZGERALD R,PIRMOHAMED M.Aspirin resistance:effect of clinical,biochemical and genetic factors[J].Pharmacol Ther,2011,130(2):213-225.
[5]JUSSEN D,HORN P,VAJKOCZY P.Aspirin resistance in patients with hemodynamic cerebral ischemia undergoing extracranial-intracranial bypass surgery[J].Cerebrovasc Dis,2013,35(4):355-362.
[6]FITZGERALD R,PIRMOHAMED M.Aspirin resistance:effect of clinical,biochemical and genetic factors[J].Pharmacol Ther,2011,130(2):213-225.
[7]GAZOULI M.Genetics in anti-platelet treatment[J].Curr Pharm Des,2016,22(29):4506-4511.
[8]KOBZAR G,MARDLA V,SAMEL N.Short-term exposure of platelets to glucose impairs inhibition of platelet aggregation by cyclooxygenase inhibitors[J].Platelets,2011,22(5):338-344.
[9]ERTUGRUL D T,TUTAL E,YILDIZ M.Aspirin resistance is associated with glycemic control,the dose of aspirin,and obesity in type 2 diabetes mellitus[J].J Clin Endocrinol Metab,2010,95(6):2897-2901.
[10]SANTILLI F,DAVG,CONSOLI A,et al.Low-density lipoprotein-lowering medication and platelet function[J].J Am Coll Cardiol,2006,47(2):391-397.
[11]KOHLI P,GIUGLIANO R P.Low-density lipoprotein lowering in2013 by nonstatin agents:the discovery and development of promising novel targeted therapies[J].J Cardiovasc Pharmacol Ther,2013,18(3):199-210.
[2]OZBEN S,OZBEN B,TANRIKULU A M,et al.Aspirin resistance in patients with acute ischemic stroke[J].J Neurol,2011,258(11):1979-1986.
[3]CAI G,ZHOU W,LU Y.Aspirin resistance and other aspirin-related concerns[J].Neurol Sci,2016,37(2):181-189.
[4]FITZGERALD R,PIRMOHAMED M.Aspirin resistance:effect of clinical,biochemical and genetic factors[J].Pharmacol Ther,2011,130(2):213-225.
[5]JUSSEN D,HORN P,VAJKOCZY P.Aspirin resistance in patients with hemodynamic cerebral ischemia undergoing extracranial-intracranial bypass surgery[J].Cerebrovasc Dis,2013,35(4):355-362.
[6]FITZGERALD R,PIRMOHAMED M.Aspirin resistance:effect of clinical,biochemical and genetic factors[J].Pharmacol Ther,2011,130(2):213-225.
[7]GAZOULI M.Genetics in anti-platelet treatment[J].Curr Pharm Des,2016,22(29):4506-4511.
[8]KOBZAR G,MARDLA V,SAMEL N.Short-term exposure of platelets to glucose impairs inhibition of platelet aggregation by cyclooxygenase inhibitors[J].Platelets,2011,22(5):338-344.
[9]ERTUGRUL D T,TUTAL E,YILDIZ M.Aspirin resistance is associated with glycemic control,the dose of aspirin,and obesity in type 2 diabetes mellitus[J].J Clin Endocrinol Metab,2010,95(6):2897-2901.
[10]SANTILLI F,DAVG,CONSOLI A,et al.Low-density lipoprotein-lowering medication and platelet function[J].J Am Coll Cardiol,2006,47(2):391-397.
[11]KOHLI P,GIUGLIANO R P.Low-density lipoprotein lowering in2013 by nonstatin agents:the discovery and development of promising novel targeted therapies[J].J Cardiovasc Pharmacol Ther,2013,18(3):199-210.