替格瑞洛对不稳定型心绞痛患者血清炎症因子的影响

Effect of ticagrelor on serum inflammatory cytokines in patients with unstable angina

目的观察血小板二磷酸腺苷（ADP）受体拮抗剂替格瑞洛与氯吡格雷对不稳定型心绞痛（UA）患者血清超敏C-反应蛋白（hs—CRP）、肿瘤坏死因子-α（TNF-α）水平的影响，并探讨其可能的发生机制。方法将84例UA患者随机分为A、B两组，每组42例。A组采用替格瑞洛联合阿司匹林治疗，B组采用氯吡格雷联合阿司匹林治疗，同时另选健康体检者40例作为C组。分别在用药前、用药30d后抽取空腹静脉血，检测血清hs—CRP、TNF—α的水平变化。结果用药前：A、B两组患者血清hs—CRP、TNF-α水平明显高于C组（P〈0．05），A、B两组之间hs—CRP、TNF-α水平比较差异未见统计学意义；用药30d后：A、B两组患者hs—CRP、TNF-α水平较用药前明显下降，差异有统计学意义（P〈0．05），且A组患者血清hs—CRP、TNF-α水平显著低于B组（P〈0．05）。结论替格瑞洛具有抗炎作用，较氯吡格雷可显著降低血清炎症因子水平。

Objective To compare the effects of platelet adenosine diphosphate （ADP） receptor antagonist between ticagrelor and clopidogrel on serum hypersensitive c-reactive protein（hs-CRP） , tumor necrosis factor alpha（TNF-α） levels in patients with unstable angina（ UA）, and explore the likely mechanism. Methods Eighty-four patients with UA were randomly divided into group A and group B with 42 cases in each group . The patrents in group A received ticagrelor combined with aspirin therapy, and the patrents in group B received clopidogrel combined with aspirin treatment, while 40 cases of healthy physical examination were selected as group C at the same time. A fasting venous blood was taken to detect the levels of serum hs-CRP, TNF-α before and 30 days after treatment respectively. Results Before treatment,the serum hs-CRP and TNF-α levels in group A and B were significantly higher than that in group C （P 〈 0. 05 ）. There was no statistically significant difference in the hs-CRP and TNF-α levels between group A and group B. Thirty days after treatment, the levels of hs-CRP and TNF-α in group A and group B were significantly lower than that of before treatment, the differences were statistically significant（ P 〈 0.05 ）, and the serum hs-CRP and TNF-α levels in group A were significantly lower than that in group B （ P 〈 0. 05 ）. Conclusions Ticagrelor has the anti-inflammatory effect, and it can more significantly reduce serum levels of inflammatory cytokines in comparison with clopidogrel.