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目的探讨平均血小板体积(MPV)和阿司匹林抵抗(AR)与非ST段抬高的急性冠脉综合征(ACS)患者不良心血管事件发生的相关性。方法 197例非ST段抬高的ACS患者,每日口服阿司匹林100 mg>4周,检测由ADP诱导的血小板聚集率(PAG)和Sysmex XT-1800i检测的MPV,根据PAG和MPV将患者分为4组:①MPV正常不伴阿司匹林抵抗组(对照组);②MPV正常伴阿司匹林抵抗组;③MPV升高不伴阿司匹林抵抗组;④MPV升高伴阿司匹林抵抗组,随访观察4组主要不良事件(心源性死亡、心肌梗死、血运重建)发生的比率并进行比较。结果在197例非ST段抬高的ACS患者中,4组不良事件发生率分别为12.0%、18.6%、23.4%和62.5%,其中组4(MPV升高伴阿司匹林抵抗组)与组1(对照组)比较,不良事件发生比率明显增高(62.5%vs 12.0%,P<0.0001)。结论 MPV升高和AR与非ST段抬高的ACS患者不良心血管事件的发生呈正相关,它是非ST段抬高的ACS患者的重要危险因素和独立预测因子。
Objective To investigate the association between mean platelet volume (MPV) and aspirin resistance (AR) and adverse cardiovascular events in non-ST segment elevation acute coronary syndrome (ACS) patients. Methods One hundred and ninety-seven non-ST-elevation ACS patients were treated with aspirin 100 mg daily for 4 weeks. ADP-induced platelet aggregation (PAG) and MPV detected by Sysmex XT-1800i were measured. Patients were divided into two groups according to PAG and MPV 4 groups: ①MPV normal without aspirin resistance group (control group); ②MPV normal with aspirin resistance group; ③MPV increased without aspirin resistance group; ④MPV increased with aspirin resistance group, follow-up observed in 4 groups of major adverse events Death, myocardial infarction, revascularization) occurred and compared. Results Among the 197 patients with non-ST-segment elevation ACS, the incidence of adverse events in 4 groups was 12.0%, 18.6%, 23.4% and 62.5%, respectively. The incidence of adverse events in group 4 (MPV increased with aspirin resistance) and group 1 Control group), the incidence of adverse events was significantly higher (62.5% vs 12.0%, P <0.0001). Conclusions The elevation of MPV and the incidence of adverse cardiovascular events in patients with ACS and non-ST-elevation ACS are positively correlated. It is an important risk factor and an independent predictor of non-ST-segment elevation ACS.