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高血压患者的阿司匹林抵抗。

Aspirin resistance in hypertensive patients.

机构信息

Department of Cardiology, Marmara University Faculty of Medicine, Istanbul, Turkey.

出版信息

J Clin Hypertens (Greenwich). 2010 Sep;12(9):714-20. doi: 10.1111/j.1751-7176.2010.00307.x.

Abstract

Aspirin resistance is associated with poor clinical prognosis. The authors investigated aspirin resistance in 200 hypertensive patients (111 men, age: 68.3±11.4 years) by the Ultegra Rapid Platelet Function Assay-ASA (Accumetrics Inc., San Diego, CA). Aspirin resistance was defined as an aspirin reaction unit ≥550. Aspirin resistance was detected in 42 patients. Aspirin resistance was present in 25.6% of the patients with poor blood pressure control, while in 17.8% of the patients with controlled blood pressure (P=.182). Female gender and creatinine levels were significantly higher (P=.028 and P=.030, respectively), while platelet count was significantly lower (P=.007) in aspirin-resistant patients. Multivariate analysis revealed that female gender (odds ratio [OR], 2.445; P=.045), creatinine levels (OR, 1.297; P=.015) and platelet count (OR, 0.993; P=.005) were independent predictors of aspirin resistance. The frequency of aspirin resistance is not low in hypertensive patients. Female hypertensive patients, especially, with higher creatinine levels and lower platelet count are at higher risk for aspirin resistance.

摘要

阿司匹林抵抗与不良临床预后相关。作者通过 Ultegra 快速血小板功能测定-ASA(Accumetrics Inc.,圣地亚哥,加利福尼亚州)对 200 名高血压患者(111 名男性,年龄:68.3±11.4 岁)进行了阿司匹林抵抗研究。阿司匹林抵抗定义为阿司匹林反应单位≥550。在 42 名患者中检测到阿司匹林抵抗。在血压控制不佳的患者中,阿司匹林抵抗的发生率为 25.6%,而在血压控制良好的患者中为 17.8%(P=.182)。阿司匹林抵抗患者的女性比例和肌酐水平显著升高(P=.028 和 P=.030),血小板计数显著降低(P=.007)。多因素分析显示,女性(比值比 [OR],2.445;P=.045)、肌酐水平(OR,1.297;P=.015)和血小板计数(OR,0.993;P=.005)是阿司匹林抵抗的独立预测因素。高血压患者中阿司匹林抵抗的发生率不低。女性高血压患者,尤其是肌酐水平较高和血小板计数较低的患者,发生阿司匹林抵抗的风险更高。

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