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目的:探讨60岁以上老年冠心病患者行冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后氯吡格雷抵抗的发生率和影响因素。方法:符合入选标准的患者208例,年龄61～80岁,根据对氯吡格雷的反应分为氯吡格雷抵抗组55例和氯吡格雷有反应组153例。结果:氯吡格雷抵抗的发生率26.4%。氯吡格雷抵抗组和有反应组血小板聚集率(platelet aggregation rate,PAR)分别为(57±6)%和(35±9)%(P<0.01)。多因素logistic回归分析提示Ⅱ型糖尿病[P=0.037,优势比(OR)=2.053,95%置信区间1.045-4.034]是氯吡格雷抵抗的影响因素。结论:60岁以上老年冠心病患者PCI术后氯吡格雷抵抗的发生率26.4%,Ⅱ型糖尿病是氯吡格雷抵抗的影响因素。
Objective: To investigate the incidence and influencing factors of clopidogrel resistance after percutaneous coronary intervention (PCI) in elderly patients with coronary heart disease over 60 years old. Methods: A total of 208 eligible patients were enrolled in this study, ranging in age from 61 to 80 years. According to the responses to clopidogrel, 55 were included in the clopidogrel resistance group and 153 in the clopidogrel response group. Results: The incidence of clopidogrel resistance was 26.4%. (57 ± 6)% and (35 ± 9)% (P <0.01), respectively, in the clopidogrel resistance and response groups. Multivariate logistic regression analysis revealed that type 2 diabetes [P = 0.037, odds ratio (OR) = 2.053, 95% confidence interval 1.045-4.034] was the influencing factor for clopidogrel resistance. Conclusion: The incidence of clopidogrel resistance in elderly patients with coronary heart disease over 60 years old after PCI is 26.4%. Type 2 diabetes is the influencing factor of clopidogrel resistance.