替格瑞洛和西洛他唑治疗冠心病合并糖尿病PCI术后血栓形成的比较研究

Comparative study on ticagrelor and cilostazol in treatment of thrombosis of coronary heart disease with diabetes after PCI

目的比较替格瑞洛和西洛他唑治疗冠心病合并糖尿病PCI术后血栓形成的临床疗效。方法选取2014年1月—2016年1月在沧县医院接受PCI手术治疗的冠心病合并糖尿病患者88例,随机分为对照组(44例)和治疗组(44例)。对照组患者口服西洛他唑片,100 mg/次,2次/d;治疗组口服替格瑞洛片,第1天180 mg/次,1次/d,以后90 mg/次,2次/d。两组患者均治疗30 d。比较两组治疗前后血小板抑制率、血清细胞因子水平和心血管不良事件发生率。结果治疗后,两组患者血小板抑制率均明显升高(P<0.05),且与对照组相比,治疗组患者升高更显著,两组比较差异有统计学意义(P<0.05)。治疗后,两组血清超敏反应C蛋白(hs-CRP)、IL-6、CD40L、脂蛋白磷脂酶A2(Lp-PLA2)水平均明显低于同组治疗前,同组比较差异具有统计学意义(P<0.05),且治疗后治疗组比对照组降低更明显,两组比较差异具有统计学意义(P<0.05)。治疗过程中,治疗组心血管不良事件发生率为11.36%,显著低于对照组的29.55%,两组比较差异有统计学意义(P<0.05)。结论替格瑞洛可更好的拮抗冠心病合并糖尿病PCI术后血小板聚集,并可有效降低机体炎症因子水平,具有一定的临床推广应用价值。

Objective To compare clinical curative effect of ticagrelor and cilostazol in treatment of thrombosis of coronary heart disease with diabetes after PCI. Methods Patients（88 cases） with coronary heart disease with diabetes treated with PCI in Cangxian Hospital from January 2014 to January 2016 were randomly divided into control（44 cases） and treatment（44 cases） groups. Patients in the control group were po administered with Cilostazol Tablets, 100 mg/time, twice daily. Patients in the treatment group were po administered with Ticagrelor Tablets, 180 mg/time for first day, then 90 mg/time, twice daily. Patients in two groups were treated for 30 d. After treatment, the platelet inhibitory rate, serum cytokines level, and adverse cardiovascular events in two groups before and after treatment were compared. Results After treatment, the platelet inhibitory rate in two groups was significantly increased（P〈0.05）, and compared with the control group, platelet inhibitory rate in the treatment group was significantly increased, with significant difference between two groups（P〈0.05）. After treatment, the hs-CRP, IL-6, CD40 L, and Lp-PLA2 levels in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. And the serum cytokines levels in the treatment group were significantly lower than those in the control group, with significant difference between two groups（P〈0.05）. In the course of treatment, the adverse cardiovascular event rate in the treatment group was 11.36%, which were significantly lower than 29.55% in the control group, and there were differences between two groups（P〈0.05）. Conclusion Ticagrelor can effectively antagonize the platelet aggregation after PCI of coronary heart disease with diabetes, and reduce the inflammatory factor, which has a certain clinical application value.