| Background: Old people are the most common among the ischemic cardiovascular and cerebrovascular diseases, in the project of prevention and therapy about ischemic cardiovascular and cerebrovascular diseases, antiplatelet drugs play a more and more important role in our daily life ,there are enough evidences that antiplatelet drugs can decrease remarkable the harmful cases of cardiovascular and cerebrovascular in old patients. Currently, cloidogrel that is a sort of thienopyridine in antiplatelet drugs has been used widely in cardiovascular and cerebrovascular diseases ,clopidogrel is a new type platelet inhibitor, it inhibit platelet agglutinin by ADP pathway irreversibly ,it has become an important antiplatelet agent for the reason than it has excellent effect and rare side-effects. However, recent studies have showed that some patients have hypoergy or inexcitability to clopidogrel. But materials about clopidogrel resistance in super aged are scarce.Objective: The rate of platelet aggregation was observed in old patients of taking cloidogrel. At the same time, our study was designed to investigate the incidence rate and influential factors of clopidogrel resistance in old people.Methods: One hundred and sixteen patients were collected from the people who were hospitalized in PLA General Hospital during January 2007 to Febuary 2008, including 95males and 21 females, with a mean age of 81.3±6.4. According to following standards: more than 70 years old, clopidogrel medication for the first time or drug withdraw of clopidogrel for at least 7 days, no ticlopidine or heparin medication, no acute or chronic hematological system diseases, platelet is more than 100 thousand, without severe liver or kidney disfunction, no bleeding, cancer or diseases of immune system . At the same time, ten healthy volunteers were collected, including 7 males and 3 females, with a mean age of 33.6±7.6 . Blood biochemistry markers, blood clotting markers, glycosylated hemoglobin, RPA, were analysed before treatment. The age, sex, smoking, baseline disease and drugs were analyzed. Medication is 75mg clopidogrel per day. 5μmol/L ADP was used as stimulus to detect the rate of platelet aggregation (RPA) on baseline and 8 days after medication. The difference ofΔRPA [%]≤10% is regarded as the standard of clopidogrel resistance (CR) and the patients were separated into two groups: CR group and non-CR group. At the same time, we collected randomly 10 patients from the people who wereΔRPA[%]≤10%, medication is 300mg clopidogrel one time, to investigate rate of platelet aggregation at the morning of second day.Results: The rate of platelet aggregation was decreased obvious after taking clopidogrel in experimental group and control group. There were 27 cases of clopidogrel resistance (23.3 %) among the 116 experimental group. There were 2 cases of clopidogrel resistance (20 %) among the control group. Diabetic group has higher incidence of CR (P < 0.01). Other clinical characters and blood marker had no differences. We collected randomly 10 patients from the people who wereΔRPA[%]≤10%, medication is 300mg clopidogrel one time ,there are four peopleΔRPA[%]≥10%, but the change of the rate of platelet aggregation was meaningless.Conclusion: 1 .The rate of platelet aggregation was decreased obvious in experimental group and control group; 2. The incidence of clopidogrel resistance is 23.3% in old people; 3. Clopidogrel resistance have possible relations to taking aspirin, dose of clopidogrel, diabetes mellitus and so on. 4. Clopidogrel resistance have impossible relations to age, drugs of hypertension and so on.
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