西洛他唑对不稳定型心绞痛病人炎性因子的影响

THE EFFECT OF CILOSTAZOL ON SERUM LEVEL OF sICAM-1,sVCAM-1 AND MMP-9 IN PATIENTS WITH UNSTABLE ANGINA

目的探讨西洛他唑对不稳定型心绞痛(UA)病人炎性因子的影响。方法142例诊断明确的UA病人,随机分为阿司匹林组(A组)、阿司匹林+西洛他唑组(B组)、阿司匹林+氯吡格雷组(C组)和阿司匹林+西洛他唑+氯吡格雷组(D组)。同时以28例健康体检人员作为正常对照组。观察各组病人疗效及炎性因子的变化。结果治疗前UA病人血清可溶性黏附因子(sICAM-1)、血管细胞黏附因子(sVCAM-1)、血浆基质金属蛋白酶(MMP-9)浓度均显著高于正常对照组(F=29.11～94.97,q=3.40～22.76,P<0.05)。各组在治疗后1周、1个月的浓度值均较治疗前下降,且随着时间的延长,血清sICAM-1、sVCAM-1、MMP-9水平降低趋势也增加,以D组降幅最大,A组降幅最小,B、C组降幅相近。1年内不良临床事件发生率D组最低,A组最高,各组药物不良反应发生率相近。结论西洛他唑治疗UA具有一定的临床价值。

Objective To investigate the effect of cilostazol on serum level of slCAM-1, sVCAM-1, and MMP-9 in pa- tients with unstable angina （UA）. Methods This study consisted of 142 patients with confirmed unstable angina in four groups： A, aspirin-treatment group; B, cilostazol-and-aspirin-treatment group; C, aspirimand clopidogrel-treatment group; and D, aspirin-cilostazol and clopidogrel treatment group. Twenty-eight age-matched healthy individuals were selected as controls. The serum level of sICAM-1, sVCAM-1 and MMP-9 were compared among them. Therapeutic effect was evaluated. Results Before treatment, the serumsICAM-1, sVCAM-1 and MMP-9 in the patients was higher than that in the controls （P〈0.05）. The serum sICAM-1, sVCAM-1, and MMP-9 decreased in each group after one week or one month of treatment and there was a tendency of decreasing with the extend of duration, in which, group D decreased the most, and group A, the least. The occurrence of adverse effect within one year was seen least in group D, and most in group A. The incidence of side effects among the groups was closed to each other. Conclusion Cilostazol is valuable in clinical application.