STEMI患者血管生成素样蛋白2的表达及替格瑞洛与氯吡格雷的影响

Levels of angptl 2 in patients with acute ST-segment elevation myocardial infarction and comparative effect between Ticagrelor and Clopidogrel

目的:探讨急性ST段抬高型心肌梗死(STEMI)患者血清血管生成素样蛋白2(Angptl 2)的表达及观察替格瑞洛与氯吡格雷两种抗血小板药对其浓度的影响。方法:入选同期入住我院心血管科患者40例为对照组,接受急诊PCI术的急性STEMI患者125例作为研究组,后者又随机分为替格瑞洛组(A组)50例(采用替格瑞洛联合阿司匹林治疗)和氯吡格雷组(B组)75例(采用氯吡格雷联合阿司匹林治疗),分别检测术前、术后24h、术后1周、术后1个月血清Angptl 2水平。结果:急性STEMI患者Angptl 2水平显著高于对照组(P<0.05);入院时A、B两组Angptl 2水平无明显差异(P>0.05),术后24h两组血清Angptl 2水平升高,但两组差异无统计学意义(P>0.05),术后1周及术后1个月时A组较B组Angptl 2水平明显降低,差异有统计学意义(P<0.05)。结论:Angptl 2可作为急性心肌梗死的重要风险预测指标,替格瑞洛较氯吡格雷更强的降低炎性因子Angptl 2的水平,提高动脉粥样硬化斑块的稳定性。

Objective：To investigate levels of serum angptl 2in patients with acute ST-segment Elevation myocardial Infarction and compare effect on its concentration between two antiplatelet medications.Method：The 40 patients at cardiovascular division in our hospital were selected as control group in the same period,125 patients with STEMI after emergency PCI were selected as experiment group and randomly divided into ticagrelor group（group A）with 50 cases,who recieved ticagrelor combined with aspirin treatment and clopidogrel group（groupB）75cases,which recieved clopidogrel combined with aspirin treatment.Angptl 2was measured before surgery and24 hours,1week,1month after surgery respectively.Result：The levels of serum angptl 2in experimental group were significantly higher than that in control group（P〈0.05）.There was no statistical significance in angptl 2levels between two groups before surgery（P〉0.05）.Angptl 2levels of 24 hours after surgery increased in both groups,but it has no statistically significant difference（P〉0.05）.Angptl 2levels of 1week and 1 month after surgery were lower in group A than group B,the difference was statistically significant（P〈0.05）.Conclusion：Angptl 2can be used as an important risk marker in acute myocardial infarction.Ticagrelor has stronger capacity than clopidogrel in reducing Angptl 2levels and in improving the stability of atherosclerotic plaques.