替格瑞洛对急性冠脉综合征患者动脉炎性反应及心功能的影响研究

Effect of Ticagrelor on Arterial Inflammatory Reaction and Cardiac Function in Patients With Acute Coronary Syndrome

目的探讨替格瑞洛对急性冠状动脉综合征(ACS)患者动脉炎性反应、血小板聚集率(PAR)及心功能的影响。方法于2014年1月—2015年2月选取在新疆维吾尔自治区中医医院心血管内科住院治疗的ACS患者80例,根据就诊顺序,将其分为对照组和观察组各40例。对照组在常规治疗基础上口服氯吡格雷,观察组在常规治疗基础上口服替格瑞洛,用药时间均为1个月,随访6个月。比较两组治疗前后的炎性因子水平、PAR、心功能指标、治疗和随访过程中的不良反应发生情况。结果两组性别、平均年龄、合并症、疾病类型及既往心肌梗死史比较,差异无统计学意义(P>0.05)。治疗前两组超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、基质金属蛋白酶9(MMP-9)及白介素6(IL-6)比较,差异无统计学意义(P>0.05);治疗后两组hs-CRP、TNF-α、MMP-9及IL-6比较,差异有统计学意义(P<0.05);治疗后两组hs-CRP、TNF-α、MMP-9及IL-6与治疗前比较,差异均有统计学意义(P<0.05)。治疗前两组PAR比较,差异无统计学意义(P>0.05);治疗后两组PAR比较,差异有统计学意义(P<0.05);治疗后两组PAR与治疗前比较,差异均有统计学意义(P<0.05)。治疗前两组舒张早期充盈峰速度与舒张晚期充盈峰速度比值(E/A)、左心室舒张末期直径(LVEDD)及左心室射血分数(LVEF)比较,差异无统计学意义(P>0.05);治疗后两组E/A、LVEDD及LVEF比较,差异有统计学意义(P<0.05);治疗后两组E/A、LVEDD及LVEF与治疗前比较,差异均有统计学意义(P<0.05)。治疗及随访期间,两组均无重大不良心血管事件发生。结论替格瑞洛可以减轻ACS患者的动脉炎性反应,增强抗血小板聚集作用,改善患者心功能,且不良反应较少。

Objective To investigate the influence of ticagrelor on arterial inflammatory reaction,platelet aggregation rate（ PAR） and cardiac function in patients with acute coronary syndrome（ ACS）.Methods We enrolled 80 ACS patients who were admitted into the Department of Cardiovascular Medicine of Chinese Medicine Hospital of the Xinjiang Uygur Autonomous Region from January 2014 to February 2015.According to the sequence of visiting doctors,the patients were divided into two groups： control group（ n = 40） and observation group（ n = 40）.The control group was orally administrated with clopidogrel on the basis of conventional treatment,and the observation group was orally administrated with ticagrelor on the basis of conventional therapy,and the medication lasted for 1 month and the follow- up lasted for 6 months.Comparison was made between the two groups in inflammatory factor level,PAR,cardiac function,adverse reactions during treatment and follow-up.Results The two groups were not significantly different in gender,average age,complications,category of disease and the history of myocardial infarction（ P〉0.05）; after treatment,the levels of hs- CRP,TNF- α,MMP- 9 and IL- 6 of the two groups were significantly different from those before treatment（ P〈0.05）.Before treatment, the two groups were not significantly different in hs- CRP, TNF- α, MMP- 9 and IL- 6（ P〉0.05）; after treatment, the two groups were significantly different in hs- CRP, TNF- α, MMP- 9 and IL- 6（ P〈0.05）.After treatment, the levels of hs- CRP,TNF- α,MMP- 9 and IL- 6 of the two groups were significantly different from those before treatment（ P〈0.05）.Before treatment,the two groups were not significantly different in PAR（ P〉0.05）; after treatment,the two groups were significantly different in PAR（ P〈0.05）; the two groups had higher PAR after treatment than those before treatment（ P〈0.05）.Before treatment,the two groups were not significantly different in E / A,LVEDD and LVEF（ P〉0.05）; after treatment, the two groups were significantly different in E / A,LVEDD and LVEF（ P〈0.05）; the two groups had higher E / A,LVEDD and LVEF than those before treatment（ P〈0.05）.No major adverse cardiovascular events were observed in the two groups during treatment and follow- up.Conclusion Ticagrelor can significantly reduce the arterial inflammatory response in patients with acute coronary syndrome.It can improve anti- platelet aggregation and cardiac function and reduce the adverse reactions.