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2型糖尿病患者中阿司匹林抵抗的患病率。

Prevalence of aspirin resistance in patients with type 2 diabetes.

作者信息

Fateh-Moghadam S, Plöckinger U, Cabeza N, Htun P, Reuter T, Ersel S, Gawaz M, Dietz R, Bocksch W

机构信息

Medizinische Klinik mit Schwerpunkt Kardiologie, Universitätsmedizin Charité-Campus Virchow, Humboldt-Universität zu Berlin und Freie Universität Berlin, Germany.

出版信息

Acta Diabetol. 2005 Jun;42(2):99-103. doi: 10.1007/s00592-005-0186-y.

Abstract

Aspirin resistance has been recognised to occur in patients with cardiovascular disease and is associated with poor clinical prognosis. The purpose of the present study was to evaluate the prevalence of aspirin resistance in 172 patients with diabetes mellitus type 2 (DM-2). Platelet function of 172 consecutive patients with type 2 diabetes on chronic aspirin therapy was evaluated. The effect of aspirin was assessed using the platelet function analyser (PFA-100) system, reporting platelet-dependent thrombus formation as the time required to close a small aperture in a biologically active membrane. Resistance to aspirin was defined as a normal collagen/epinephrine-induced closure time (82-165 s). Aspirin responders were defined when closure time was > or =300 s. Thirty-seven (21.5%) of the type 2 diabetic patients were found to be resistant to chronic aspirin therapy, 29 (16.9%) were semi-responders and 106 (61.6%) were responders. Univariate analysis revealed that aspirin non-responders were significantly younger (p<0.05) compared to aspirin responders. A significant number of type 2 diabetic patients are resistant to aspirin therapy. Aspirin resistance can be evaluated by point-of-care testing and should be recognised in diabetic patients that are treated for primary or secondary prevention.

摘要

阿司匹林抵抗已被认为在心血管疾病患者中存在,并与不良临床预后相关。本研究的目的是评估172例2型糖尿病(DM - 2)患者中阿司匹林抵抗的患病率。对172例连续接受慢性阿司匹林治疗的2型糖尿病患者的血小板功能进行了评估。使用血小板功能分析仪(PFA - 100)系统评估阿司匹林的效果,将血小板依赖性血栓形成报告为在生物活性膜中封闭一个小孔所需的时间。对阿司匹林的抵抗定义为胶原/肾上腺素诱导的正常封闭时间(82 - 165秒)。当封闭时间≥300秒时定义为阿司匹林反应者。发现37例(21.5%)2型糖尿病患者对慢性阿司匹林治疗有抵抗,29例(16.9%)为半反应者,106例(61.6%)为反应者。单因素分析显示,与阿司匹林反应者相比,阿司匹林无反应者明显更年轻(p<0.05)。相当数量的2型糖尿病患者对阿司匹林治疗有抵抗。阿司匹林抵抗可通过即时检验进行评估,并且在接受一级或二级预防治疗的糖尿病患者中应予以识别。

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