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目的探讨高同型半胱氨酸血症(HHcy)和糖尿病对阿司匹林抵抗(AR)的影响。方法选取老年T2DM患者(T2DM组)50例和非糖尿病老年人(Con)组40例,另根据是否伴HHcy分为糖尿病合并HHcy亚组(H-DM)、单纯糖尿病亚组(NH-DM)、非糖尿病合并HHcy(H-Con)亚组及单纯非糖尿病(NH-Con)亚组,均口服阿司匹林1个月以上。通过血栓弹力图法评估血小板聚集功能。结果T2DM组Hcy高于Con组[(16.60±6.58)vs(13.18±4.33)μmol/L,P<0.05],而AR发生率增高(34.0%vs 10.0%,P<0.01)。H-DM亚组胰岛素抵抗指数(HOMA-IR)高于NH-DM亚组[(3.92±2.16)vs(2.72±1.50),P<0.05],AR发生率增高(44.0%vs 24.0%,P<0.01)。Hcy水平和AR呈负相关(r=-0.558,P<0.01)。结论伴有HHcy的老年T2DM患者AR发生率较高,其导致的IR可促进这一过程的进展。
Objective To investigate the effect of hyperhomocysteinemia (HHcy) and diabetes on aspirin resistance (AR). Methods Forty elderly patients with T2DM (T2DM group) and 40 non-diabetic elderly patients (Con group) were enrolled in this study. Patients with diabetes mellitus (HHcy), simple diabetes mellitus (NH-DM) , Non-diabetic HHcy (H-Con) subgroup and simple non-diabetic (NH-Con) subgroup. All patients were given aspirin orally for more than 1 month. Platelet aggregation was evaluated by thromboelastometry. Results The Hcy in T2DM group was significantly higher than that in Con group [(16.60 ± 6.58) vs (13.18 ± 4.33) μmol / L, P <0.05], while the incidence of AR increased (34.0% vs 10.0%, P <0.01). The HOMA-IR of H-DM subgroup was higher than that of NH-DM subgroup [(3.92 ± 2.16) vs (2.72 ± 1.50), P <0.05], and the incidence of AR was higher (44.0% vs 24.0%, P <0.01). The level of Hcy was negatively correlated with AR (r = -0.558, P <0.01). Conclusion The incidence of AR in elderly T2DM patients with HHcy is high, and the resulting IR can promote the progress of this process.