氯吡格雷联合阿司匹林对急性心肌梗死炎性指标及心肌再灌注的影响

Effects of Clopidogrel Combined with Aspirin on Inflammatory Indexes and Myocardial Reperfusion in Patients with Acute Myocardial Infarction

目的:探讨氯吡格雷联合阿司匹林对急性心肌梗死患者炎性指标及心肌再灌注的影响。方法:选取2018年1月—2020年1月在我院接受治疗的急性心肌梗死患者87例,依据盲抽法分为对照组(n=43)与观察组(n=44)。两组均给予常规治疗,对照组予以阿司匹林联合替格瑞洛,观察组在对照组基础上加用氯吡格雷,比较两组临床疗效、炎性指标、心肌再灌注及不良反应发生率等。结果:总有效率观察组为97.73%,对照组为81.40%,组间差异有统计学意义(P<0.05)。治疗后,两组TNF-α、ICAM-1、IL-8水平均较治疗前降低,且观察组较对照组更低,差异有统计学意义(P<0.05);两组LVEF水平较治疗前升高,WMSI水平较治疗前降低,且观察组的升降幅度均较对照组大,差异均有统计学意义(P<0.05)。两组不良反应发生率比较,观察组低于对照组,但差异无统计学意义(P>0.05)。结论:氯吡格雷联合阿司匹林治疗急性心肌梗死效果显著,可有效抑制机体炎性反应,提升心肌再灌注水平,且安全性高。

Objective:To investigate the effect of clopidogrel combined with aspirin on inflammatory indexes and myocardial reperfusion in patients with acute myocardial infarction.Methods:87 patients with acute myocardial infarction in our hospital from January 2018 to January 2020 were selected and randomly divided into control group(n=43)and observation group(n=44).Both groups were given conventional treatment,the control group was given aspirin combined with ticagrelor,and the observation group was given clopidogrel on the basis of the control group.The clinical efficacy,inflammatory indexes,myocardial reperfusion and incidence of adverse reactions were compared between the two groups.Results:The total effective rate was 97.73%in the observation group and 81.40%in the control group,the difference was statistically significant(P<0.05).After treatment,the levels of TNF-α,ICAM-1 and IL-8 in the two groups were lower than those before treatment,and the observation group was lower than the control group,the difference was statistically significant(P<0.05);the LVEF level in the two groups was higher than that before treatment,and the WMSI level was lower than that before treatment,and the fluctuation range of the observation group was larger than that of the control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion:Clopidogrel combined with aspirin in the treatment of acute myocardial infarction has significant effect,can effectively inhibit the inflammatory reaction of the body,improve the level of myocardial reperfusion,and has high safety.