糖化血红蛋白水平对稳定型心绞痛患者阿司匹林介导的血小板聚集率及不良心血管事件风险的影响OA
Impact of Glycated Hemoglobin Levels on Aspirin-Mediated Platelet Aggregation and Risk of Adverse Cardiovascular Events in Patients with Stable Angina Pectoris
目的:探讨糖化血红蛋白(HbA1c)水平对稳定型心绞痛(SAP)患者阿司匹林介导的血小板聚集率(PA)的影响.方法:选取 2023 年 1 月—2025 年 6 月于滨州市中心医院确诊为 SAP 并长期规律服用阿司匹林(100 mg/d)的 120 例患者为研究对象,按照 HbA1c 水平将其分为达标组(HbA1c<6.5%,n=60)和高水平组(HbA1c≥6.5%,n=60).采用光学比浊法测定花生四烯酸(AA,浓度 0.5 mmol/L)诱导的血小板最大聚集率;对全部患者进行为期 6 个月的随访,记录两组主要不良心血管事件(MACE)(包括急性心肌梗死、不稳定性心绞痛再住院、心源性死亡、缺血性卒中)的发生情况;探讨 HbA1c 与 PA 的关系.结果:高水平组的空腹血糖(FBG)、低密度脂蛋白胆固醇(LDL-C)及 HbA1c 水平明显高于达标组,差异有统计学意义(P<0.05).高水平组的AA 诱导的 PA 明显高于达标组,差异有统计学意义(P<0.05).Pearson 相关分析显示,HbA1c 水平与 AA 诱导的 PA 呈明显正相关(r=0.528,P<0.001).随访 6 个月期间,高水平组 MACE 总发生率明显高于达标组,差异有统计学意义(P<0.05).多因素 Cox 回归分析显示,血糖升高、HbA1c 水平升高和 PA 增加是 SAP 患者发生 MACE 的独立危险因素,差异有统计学意义(P<0.05).结论:高水平 HbA1c 及高血糖可明显削弱阿司匹林对 SAP 患者血小板聚集的抑制作用,增加"阿司匹林抵抗"发生风险,且与患者远期MACE 风险升高密切相关.
Objective:To investigate the impact of glycated hemoglobin(HbA1c)levels on aspirin-mediated platelet aggregation(PA)in patients with stable angina pectoris(SAP).Method:A retrospective analysis was conducted on 120 patients diagnosed with SAP in the hospital from January 2023 to June 2025 who were on long-term regular aspirin therapy(100 mg/d).According to their HbA1c levels,they were divided into a target group(HbA1c<6.5%,n=60)and a high-level group(HbA1c≥6.5%,n=60).The maximum platelet aggregation rate induced by arachidonic acid(AA,concentration 0.5 mmol/L)was measured using optical aggregometry.All patients were followed up for 6 months,and the occurrence of major adverse cardiovascular events(MACE,including acute myocardial infarction,rehospitalization for unstable angina,cardiac death,and ischemic stroke)was recorded in both groups.The relationship between HbA1c and platelet aggregation rate was explored.Result:Fasting blood glucose(FBG),low-density lipoprotein cholesterol(LDL-C),and HbA1c levels were significantly higher in the high-level group than in the target group(P<0.05).The AA-induced platelet aggregation rate was significantly higher in the high-level group compared with the target group(P<0.05).Pearson correlation analysis showed that HbA1c levels were significantly positively correlated with AA-induced platelet aggregation rate(r=0.528,P<0.001).During the 6-month follow-up period,the total incidence of MACE was significantly higher in the high-level group than in the target group(P<0.05).Multivariate Cox regression analysis indicated that elevated blood glucose,elevated HbA1c level and increased PA are independent risk factors for MACE in SAP patients,and the difference is statistically significant(P<0.05).Conclusion:High levels of glycated hemoglobin and FBG can significantly impair aspirin's inhibitory effect on platelet aggregation in patients with stable angina pectoris,increase the risk of"aspirin resistance",and are closely associated with a higher long-term risk of adverse cardiovascular events.
张小娟;魏兆丽;丁玲岩;刘艳;李秀征
滨州市中心医院 山东 滨州 251700滨州市中心医院 山东 滨州 251700滨州市中心医院 山东 滨州 251700滨州市中心医院 山东 滨州 251700滨州市中心医院 山东 滨州 251700
糖化血红蛋白稳定型心绞痛阿司匹林血小板聚集率不良心血管事件
Glycated hemoglobinStable angina pectorisAspirinPlatelet aggregation rateAdverse cardiovascular events
《中外医学研究》 2026 (10)
46-49,4
2022年滨州市中心医院科研计划项目(2022KJ009)
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