硫酸氢氯吡格雷对非ST段抬高急性冠脉综合征患者血清hs-CRP及sCD40L的影响

Effects of clopidogrel bisulfate on hs-CRP and sCD40L in patients with non- ST-segment elevationacute coronary syndromes

目的观察硫酸氢氯吡格雷（波立维，Plavix）对非ST段抬高急性冠脉综合征（NSTE-ACS）患者血清高敏C反应蛋白（hs-CRP）及可溶性CD40配体（sCD40L）的影响。方法将40例NSTE-ACS患者随机分为两组：常规治疗组20例和氢氯吡格雷治疗组20例（在常规治疗基础上加用氢氯吡格雷，首次顿服300mg，次日起75mg／d，连服14d）。采用酶联免疫吸附法（ELISA）测定全部患者治疗前、后血清hs-CRP及sCD40L浓度。结果两组患者治疗后，血清hs-CRP、sCD40L浓度均较治疗前显著降低（P〈0．05）;氢氯吡格雷治疗组治疗前、后血清hs-CRP、sCD40L降低程度较常规治疗组更为显著（P〈0．05）。结论NSTE-ACS患者在常规治疗基础上加用氢氯吡格雷能明显降低血清hs-CRP、sCD40L浓度，有效减轻动脉粥样硬化炎症反应，降低动脉粥样斑块不稳定性。

Objective To observe the effects of clopidogrel bisulfate on serum hs-CRP and soluble CD40 ligand （ sCD40L ） in patients with non-ST-segment elevation acute coronary syndromes （ NSTE-ACS ）. Methods 40 patients with NSTE-ACS were randomly divided into control group （ 20 patients ） and clopidogrel bisulfate group （ 20 patients ）. The latter group received oral clopidogrel at a loading dose of 300 mg on the first day and then 75 mg daily from the second day for 14 days in addition to conventional therapy. Enzyme-linked immunosorbent assay was used to measure serum levels of hs- CRP and sCD40L in all the patients before and after treatment. Resulls After treatment, levels of hs-CRP and sCD40L were significantly decreased in both groups （ P〈 0.05 ）. The decreased levels of hs-CRP and sCD40L were more significant in the clopidogrel bisulfate group than in the control group （ P〈 0.05 ）. Conclusions Clopidogrel bisulfate combined with conven- tional therapy can significantly decrease serum levels of hs-CRP and sCD40L in patients with NSTE-ACS, effectively relieve inflammatory reaction of atherosclerosis, and reduce unstability of atheromatous plaque.