目的 探討冠心病合并糖尿病患者行經(jīng)皮冠狀動(dòng)脈介入治療后CD62p與氯吡格雷抵抗的相關(guān)性研究。方法 選擇2013年8月-2016年12月在北京市昌平區(qū)醫(yī)院行經(jīng)皮冠狀動(dòng)脈介入治療的冠心病合并糖尿病患者150例，所有患者手術(shù)前后接受氯吡格雷治療，比較患者治療前后血小板聚集率的變化情況，根據(jù)血小板聚集率變化的幅度是否 ≥ 10%，將患者分為氯吡格雷有效（C2）組和氯吡格雷抵抗（C1）組，分別檢測(cè)兩組患者CD62p以及血小板最大聚集率（PAGM）的水平，并分析其變化與血小板聚集率變化情況的相關(guān)性。結(jié)果 經(jīng)治療，患者血小板聚集率較治療前均顯著降低，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。根據(jù)血小板聚集率下降幅度分為C1組（57例）和C2組（93例），其中C1組患者CD62p較治療前顯著降低，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；C2組患者CD62p、PAGM較治療前均顯著降低，且變化幅度顯著大于C1組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；C2組治療前后CD62p的變化幅度與PAGM下降幅度的相關(guān)性（r=0.424，P=0.001）優(yōu)于C1組（r=0.387，P=0.020）。結(jié)論 氯吡格雷對(duì)冠心病合并糖尿病患者行經(jīng)皮冠狀動(dòng)脈介入治療后血小板的活性具有一定的抑制作用，氯吡格雷抵抗可能與血小板活性狀態(tài)相關(guān)。

Objective To explore the correlation between CD62p and clopidogrel resistance in patients undergoing percutaneous coronary intervention with coronary heart disease combined with diabetes mellitus. Methods 150 patients ndergoing percutaneous coronary intervention with coronary heart disease combined with diabetes mellitus were enrolled in our hospital from August 2013 to December 2016, of all patients accepted clopidogrel treatment, the platelet aggregation rate were analyzed before and after treatment, which all patients divided into two groups as the range of decreasing platelet aggregation rate whether ≥ 10%, clopidogrel effective group (C2) and clopidogrel resistance group (C1) were detected CD62p and platelet aggregation maximum (PAGM), the relevance of which range with platelet aggregation rate was analyzed. Results After treatment, the platelet aggregation rate of all patient decreased significantly (P < 0.05). Of all patients divided into clopidogrel effective group (C2) and clopidogrel resistance group (C1) as the range of decreasing platelet aggregation rate, and the CD62p of Group C1 decreased compared with before treatment (P < 0.05), the level of CD62p and PAGM in Group C2 were decreasing compared with pre-treatment, and the range of which was larger than those Group C1 (P < 0.05). The reference of CD62p and PAGM in Group C2 (r=0.424, P=0.001) was better than that Group C1 (r=0.387, P=0.020). Conclutions Clopidogrel for patients undergoing percutaneous coronary intervention with coronary heart disease combined with diabetes mellitus possessed inhibition for platelet activity, and clopidogrel resistance might be associated with platelet activity.