三联抗血小板药物对非ST段抬高性急性冠脉综合征患者血清炎症因子及内皮功能的影响

Effects of triple antiplatelet therapies on inflammatory factor and endothelium function in non-ST-elevation ACS

目的探讨短期三联抗血小板药物对非ST段抬高性急性冠脉综合征(ACS)患者血清炎症因子和血管内皮功能的影响,为三联抗血小板药物治疗非ST段抬高性ACS提供进一步的临床依据。方法急性非ST段抬高性ACS患者82例,随机分为三联抗血小板药物治疗组(治疗组)和二联抗血小板治疗组(对照组);观察组患者给予阿司匹林、氯吡格雷、替罗非班三联抗血小板药物;对照组患者给予阿司匹林,氯吡格雷二联抗血小板药物。观察治疗48 h后患者血清炎症因子(hs-CRP、IL-6)及反映血管内皮功能的指标(ET-1、NO、PGI2)的水平变化情况。结果三联抗血小板药物较二联抗血小板药物更有效地降低非ST段抬高性ACS患者血清炎症因子及改善血管内皮功能,主要的不良反应为皮下瘀斑、牙龈出血。结论对于非ST段抬高性ACS患者,三联抗血小板药物在短期的抗炎、改善血管功能方面要优于二联抗血小板治疗,值得临床推广应用。

Objective To provide more clinical evidences of triple antiplatelet drugs for the treatment of non-ST-segment elevation ACS, we explored the effects of short-term triple antiplatelet drugs to inflammatory factors and endothelial function in non-ST-segment elevation acute coronary syndrome （ACS） patients. Methods 82 non-ST-segment elevation ACS patients were divided into two groups randomly, the control group were administered dual anti platelet drugs, aspirin and clopidogrel. While the observation group were administered triple antiplatelet drugs, aspirin, elopi- dogrel and tirofiban. The changes of inflammatory factor （hsCRP, IL6） and the endothelium fune- tion（ET-1, NO, PGI2） 48hrs after treatment were observed. Results Compared with the dual an- tiplatelet drugs therapy, the triple antiplatelet drugs decreased the inflammatory factor and improved the endothelium function more effectively. The main adverse effect of the antiplatelet therapy was ecchymosis in subcutaneous gingival bleeding. But the difference showed no statistical significance between the two groups. Conclusion As for the non-ST-segment elevation ACS patients, the method of triple antiplatelet drugs therapy has more effect in decreasing the inflammatory factor and improving the endothelium function. Thus it is worthy of wide clinical applications.