替格瑞洛与氯吡格雷对急性STEMI患者急诊PCI术后炎症因子的影响

Effect on Inflammatory Factors between Ticagrelor and Clopidogrel after Emergency PCI about Patients with Acute ST-segment Elevation Myocardial Infarction

为比较替格瑞洛与氯吡格雷对急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入术(PCI)术后炎症因子的影响,将176例急性STEMI且行急诊PCI术的患者分为替格瑞洛组(A组)58例、氯吡格雷常规组(B组)58例、氯吡格雷强化组(C组)60例,分别测定术前、术后12小时、术后7天、术后1个月、术后3个月、6个月时炎症因子C-反应蛋白(CRP)、白细胞介素-6(IL-6)、髓过氧物酶(MPO)、可溶性CD40受体(sCD40L)的含量,比较3组患者各炎症因子在不同时间点有无统计学差异。结果显示C组和A组较B组明显降低(P<0.05),有统计学意义,而A组较C组稍降低(P>0.05),但两者无统计学意义。由此可见,替格瑞洛的抗炎作用较常规剂量氯吡格雷作用明显增强,和强化剂量氯吡格雷作用相仿。

To compare the effect on inflammatory factors between ticagrelor and clopidogrel after emergency PCI about patients with acute ST-segment elevation myocardial infarction （STEMI）, we divide 176 cases of acute STEMI patients who were undergone emergency PCI into ticagrelor group （group A） 58 cases, conventional clopidogrel group （group B） 58eases and strenghed clopidogrel group （group C） 60 patients. Inflammatory cytokines such as C-reactive protein （CRP）, interleukin-6 （IL-6） ,myeloperoxidase （MPO） and soluble CD40 （sCD40L） were measured before surgery and 12 hours, 7 days, 1 month, 3months ,6months after surgery, compared the statistics of inflammatory factors at different time. The results showed the inflammatory factors levels of enhanced elopidogrel and ticagrelor group degrades more than conventional clopidogrel group （P〈0. 05）, there was statistical significance, while the ticagrelor group degrades slightly lower than clopidogrel strenghed group （P 〉 0. 05）, but there was no statistical significance. Thus the effect on inflammatory factors of tieagrelor is stronger than conventional clopidogrel, but near to strenghed elopidogrel.