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Objective To analyze Clopidogrel Resistance (CR) and influencing factors of coronary heart disease (CHD) with diabetes (DM) patients and evaluatc the relationship of CR and major adverse cardiovascular events (MACE) and readmission of CHD with DM patients.Methods 270 CHD patients were enrolled.Clinical conditions of CR were measured by adenosine diphosphate (ADP) induced maximum platelet aggregation rate (MPAR).After 1-year follow-up,MACE events and rehospitalization were recorded.Results CR of NDM and DM patients were 45 (33.1％) and 78 cases (58.2％) respectively,and the difference was significant (P ＜ 0.001).Factors of CR of CHD DM patients included heart rate,TG level,the number of severe coronary artery disease.MACE events of CS and CR patients were 35 (23.8％) and 47 patients (38.2％) respectively,and the difference was significant (P =0.010).The readmitted patients of CS and CR groups were 15 cases (10.2％) and 27 patients (22.0％) respectively,and the differcnce was significant (P =0.008).The MACE of CR and CS patients in DM group were 32 (41.0％) and 12 cases (21.4％) respectively,and thc difference was significant (P ＜ 0.05).The Readmitted cases of CR and CS patients in DM group were 19 (24.4％) and 5 (8.9％) respectively,and the diffcrcnce was significant (P ＜ 0.05).Conclusions CR of CHD DM patients increased significantly.The influencing factors of CR of CHDDM are including heart rate,TG level,the number of severe coronary artery disease.MACE events and rehospitalization rate were significantly increased in CHD patients with DM AR.Therefore,it should be further strengthened the anti-platelet therapy for CHD patients with DM.
ABSTRACT
Objective To evaluate the effect of acupuncture and massage combined with anterior cervical decompression and bone grafting for the treatment of cervical spondylotic myelopathy, and to analyze the mechanism of action and provide guidance for clinical prevention and treatment.Methods A total of 62 patients with cervical spondylotic myelopathy were enrolled in our hospital from October 2013 to October 2014.The patients were divided into treatment group and control group according to random number table.The control group was treated with anterior decompression and bone grafting, and the treatment group received acupuncture and massage combined with anterior cervical decompression and bone grafting and internal fixation.The changes of JOA score, TCM syndrome score, VAS score and quality of life score before and after treatment were observed and the prognosis was evaluated.Results After treatment,the JOA score, quality of life score of the two groups were significantly increased than those before treatment, while the TCM symptom scores, VAS scores were significantly decreased.The improvement effect of the treatment group was better than that of the control group(P<0.05);The prognosis of the treatment group is better than that of the control group(P<0.05).Conclusion The treatment of cervical spondylotic myelopathy with acupuncture and massage combined with anterior decompression and bone grafting and internal fixation can significantly improve the clinical efficacy and prognosis, and the safety is higher.