【摘要】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<0.053，而AR发生率增高(34.0％vs10.0％，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。
      【关键词】 老年；高同型半胱氨酸血症；糖尿病；阿司匹林抵抗

      【Abstract】Objective To investigate the combined effect of HHcy and T2DM on AR． Methods    All the participants were divided into two groups：elderly T2DM group (T2DM group，n＝50 )and elderly non-DM group(control group，n=40)．All the subjects were also divided into four subgroups according to their HHcy level：T2DM patients with HHcy subgroup(H-DM subgroup，n＝20)，T2DM patients without HHcy subgroup (NH-DM subgroup，n＝30)，non-DM patients with HHcy subgroup(H-Con
subgroup，n＝10) and non-DM patients without HHcy subgroup(NH-COn subgroup，n=30)．All patients were orally administered aspirin 100 mg daily over one month．Platelet aggregation was measured by thrombelastography (TEG)． Results Hcy level and AR incidence were both significantly higher in T2DM group than in Con group[(16.60±-6.58)vs(13.18±14.33)μmol/L，P<0.05；

34.0％ vs 10.0％，P<0.01]．HOMA-IR and AR incidence were both significantly higher in H-DM subgroup than in NH-DM subgroup r(3.92±2.16)vs(2.72士1.50)，P<0.05；44.0％vs24.0％，P<0.01]．AR was negatively correlated with Hcy 1evel(r＝-0.558，P<0.01)． Conclution    AR incidence was high in elderly
T2DM patients．The high incidence of AR will result in IR，and the induced IR will aggravate AR in return．
    【Key words]】  lderly；Hyperhomocysteinemia(HHcy)：Diabetes mellitus；Aspirin resistance(AR)