摘要
目的:探讨西洛他唑与氯吡格雷对糖尿病患者血小板聚集率的作用及其可能影响因素。方法:选择糖尿病患者1 153例,随机分为西洛他唑组(n=577)和氯吡格雷组(n=576),分别在治疗前及治疗1周后测定血小板聚集率,比较两组患者治疗前后血小板聚集率的变化差异,以及比较血脂、空腹血糖、空腹胰岛素、糖化血红蛋白、胰岛素使用剂量对血小板聚集率的影响。结果:1西洛他唑组服药前后血小板聚集率变化为(19±17)%,氯吡格雷组服药前后血小板聚集率的变化为(21±14)%,两组血小板聚集率的变化无显著差异,氯吡格雷与西洛他唑疗效相同。2三酰甘油、胰岛素使用剂量均为西洛他唑抵抗发生的独立危险因素,低密度脂蛋白胆固醇、胰岛素使用剂量为氯吡格雷抵抗发生的独立危险因素。结论:对于糖尿病患者使用西洛他唑预防心脑血管事件可能要优于氯吡格雷。
AIM： To investigate the effect of clopidogrel （PAR） in patients with type 2 diabetes mellitus （T2DM） and cilostazol on platelet aggregation rate and the possible factors that influence their effect. METHODS： There were 1 153 patients with T2DM who were randomly divided into two groups： clopidogrel group （n = 576） and cilostazol group （n = 577 ）. PAR was detected at baseline and 1 week after medication. PARs were compared between groups and the factors affecting PAR such as lipids, fasting glucose, fasting insulin, glycosylated hemoglobin and dosage of insulin were examined. RESULTS： The changes of PAR before and after medication were （ 19 ±17 ） % in clopidogrel group and （ 21 ±14） % in cilostazol group, with no significant difference between groups, suggesting that clopidogrel and cilostazol achieved a similar effect on PAR rate. Low-density lipoprotein and insulin dose were the independent risk factors of clopidogrel resistance, whereas triglycerides and insulin dose were independent risk factors of cilostazol resistance. CONCLUSION： Cilostazol may be superior to clopidogrel in preventing cardio/ cerebrovascular events in patients with diabetes.
出处
《心脏杂志》
CAS
2014年第5期579-582,587,共5页
Chinese Heart Journal
