替格瑞洛与氯吡格雷对急性非ST段抬高型心肌梗死患者经皮冠状动脉介入术后炎症因子的影响

Effect on inflammatory factors between ticagrelor and clopidogrel after PCI in acute non-ST segment elevation myocardial infarction

目的观察替格瑞洛与氯吡格雷对急性非ST段抬高型心肌梗死患者经皮冠状动脉介入(PCI)术后炎症因子的影响。方法 160例急性非ST段抬高型心肌梗死患者按术前使用抗血小板药物的不同分为试验组79例和对照组81例。试验组给予阿司匹林300 mg,替格瑞洛180 mg,以后给予阿司匹林100 mg,每天1次,替格瑞洛90 mg,每天2次;对照组给予阿司匹林300 mg,氯吡格雷600 mg,以后给予阿司匹林100 mg,每天1次,氯吡格雷75 mg,每天1次。分别测定经皮冠状动脉介入术前、术后24 h、术后7 d、术后1个月时炎症因子C-反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、可溶性CD40配体(sCD40L)的含量,观察2组患者不同时间点的炎症因子水平。结果与术前比较,2组CRP,IL-6,TNF-α在术后24 h,术后7 d,术后1个月均显著降低,sCD40L显著升高(P<0.05)。与对照组比较,试验组CRP、IL-6浓度在术后24 h、术后7 d、术后1个月均明显降低(P<0.05)。结论替格瑞洛较氯吡格雷能够显著降低急性非ST段抬高型心肌梗死患者PCI术后炎症因子的浓度。

Objective To investigate the clinical effect of inflammatory factors between ticagrelor and clopidogrel in acute non- ST segment elevation myocardial infarction in patients undergoing percutaneous coronary intervention（ PCI）. Methods A total of 160 cases of acute non- ST segment elevation myocardial infarction were divided into treatment group（ n = 79） and control group（ n = 81） with different antiplatelet drugs.Treatment group was orally given aspirin 300 mg and ticagrelor 180 mg,later aspirin 100 mg,qd,ticagrelor 90 mg,bid; control group orally given aspirin 300 mg and clopidogrel 600 mg,later aspirin 100 mg,qd,clopidogrel 75 mg,qd. The C- reactive protein（ CRP）,interleukin-6（ IL- 6）, tumor necrosis factor（ TNF- α） and soluble CD40（sCD40L） were measured before surgery and 24 h,7 d,1 month after surgery were observed between the two groups. Results Compared with before surgery,the levels of CRP,IL- 6 and TNF- α in two group were significantly decreased,and sCD40L significantly increased 24 h,7 d,1 month after surgery（ P〈0. 05）. The levels of CRP,IL- 6 in treatment group were significantly lower than those in control group,with statisticallysignificance（ P〈0. 05）. Conclusion Compared with clopidogrel,ticagrelor can reduce the concentration of inflammatory factors in patients with acute non- ST segment elevation myocardial infarction after PCI.