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目的阿司匹林抵抗患者心率变异性指标的变化。方法服用阿司匹林(100 mg/d)至少7天以上的心脑血管患者作为入选标准。二磷酸腺苷(adenosine disphosphate,ADP)和花生四烯酸(arachidonic acid,AA)作诱导剂在Chrono-log 560 Ca上测定血小板聚集功能。记录受检者24小时动态心电图。结果阿司匹林抵抗发生率为12.5%(n=21)。阿司匹林抵抗组HRV时域参数和频域参数与阿司匹林敏感组比较均有统计学意义(P<0.01)。阿司匹林抵抗组高血压患者的比率(42.9%)与阿司匹林敏感组(29.3%)比较有显著差别(P=0.01)。结论阿司匹林抵抗组HRV时域参数和频域参数与阿司匹林敏感组比较均有统计学意义,这提示我们HRV下降的患者服用阿司匹林时,要定期检测血小板聚集功能,一旦发生阿司匹林抵抗,应提示这类患者要及时调整抗血小板药物,加大阿司匹林的剂量或换用其他抗血小板药物。
Objective To investigate the changes of heart rate variability in patients with aspirin resistance. Methods Cardiac and cerebrovascular patients taking aspirin (100 mg / d) for at least 7 days or more were selected as inclusion criteria. Platelet aggregation was measured on Chrono-log 560 Ca as an inducer of adenosine disphosphate (ADP) and arachidonic acid (AA). Subjects recorded 24-hour Holter. Results The incidence of aspirin resistance was 12.5% (n = 21). Aspirin resistance group HRV time domain parameters and frequency domain parameters and aspirin sensitive group were statistically significant (P <0.01). Aspirin resistance patients with hypertension (42.9%) and aspirin sensitive group (29.3%) were significantly different (P = 0.01). Conclusion Aspirin resistance group HRV time domain parameters and frequency domain parameters were statistically significant compared with aspirin sensitive group, suggesting that our patients with HRV decline taking aspirin, to regularly detect platelet aggregation, in the event of aspirin resistance, should be prompted to such Patients should promptly adjust the anti-platelet drugs, increase the dose of aspirin or switch to other anti-platelet drugs.