氯吡格雷对非ST段抬高冠脉综合征患者炎症因子及预后的影响

Clinical study of the effect of clopidogrel on inflammatory factors and prognosis of patients with non ST segment elevation acute coronary syndrome patients

目的评价氯吡格雷对非ST段抬高冠脉综合征(NSTEACS)患者炎症因子及预后的影响。方法将我院收治的120例NSTEACS患者随机分为氯吡格雷联合阿司匹林组(观察组)和阿司匹林组(对照组),每组60例,分别于治疗前和治疗4周后检测炎症因子水平、心功能指标。结果治疗前,2组炎症因子水平、心功能指标的差异无统计学意义;治疗4周后,观察组和对照组的C-反应蛋白(CRP)(4.2±0.8)vs(7.1±1.3)mg·L-1,肿瘤坏死因子(TNF-α)(39.6±9.4)vs(66.9±11.4)pg·L-1,观察组均低于对照组;舒张早期充盈峰速度(E峰)(76.4±14.9)vs(72.1±13.6)cm·s-1,E/A值(1.4±0.2)vs(1.3±0.2),左心室射血分数(LVEF)(69.3±11.3)%vs(64.1±7.5%),左心室舒张末期直径(LVEDD)(58.3±7.8)vs(54.1±8.7),观察组均高于对照组。E峰、E/A值、LVEF、LVEDD均与CRP、TNF-α含量呈负相关。结论氯吡格雷能够有效的降低炎症因子水平、改善远期心功能。

Objective To study the effect of clopidogrel on inflammatory factors and prognosis of patients with non ST segment elevationacute coronary syndrome （NSTEACS）. Methods One hundred and twenty patients with NSTEACS in our hospital were enrolled and randomly divided into observation group （given aspirin combined with elopidogrel ） and control group （only given aspirin）. Inflammatory factor level and heart function index were detected at pretreatment and 4 - week treatment, respectively. Results Before treatment, the differences of inflammatory factor level and heart function indexe of two groups had no statistical significance; after 4 - week treatment, the levels of C - reactive protein （CRP） （4.2 ±0.8） vs （7.1 ± 1.3） mg · L^-1 and tumor necrosis factor-or （TNF-α） （39.6±9.4） vs （66.9 ±11.4） pg.L^-1 in observation group were lower than those in control group. The values of E peak （76.4 ± 14. 9） vs （72. 1 ± 13.6） cm · s^-1, E/A （1.4 ±0. 2） vs （1.3 ±0.2）, LVEF （69.3 ± 11.3）% vs （64.1 ±7.5）%, and LVEDD （58.3 ±7.8） vs （54. 1 ±8.7） in observation group were higher than those in control group. The values of E peak, E/A value, LVEF, LVEDD had negative correlation with the levels of CRP and TNF -α. Conclusion Clopidogrel can effectively decrease the levels ofinflammatory factors and improve long- term heart function of patients with NSTEACS.