氨茶碱联合氯雷他定治疗替格瑞洛相关呼吸困难的疗效及对T淋巴细胞亚群与炎性因子影响观察

Effect of Aminophylline Combined with Loratadine in the Treatment of Ticagrelor-related Dyspnea and its Influence on Tlymphocyte Subsets and Inflammatory Factors

目的:观察氨茶碱联合氯雷他定治疗替格瑞洛相关呼吸困难的疗效,及对患者外周血T淋巴细胞亚群及炎性细胞因子的影响。方法:接受冠心病治疗并被确诊为替格瑞洛相关呼吸困难患者120例随机分为干预组和对照组各60例。干预组给予氨茶碱联合氯雷他定治疗,对照组给予安慰剂治疗。观察两组临床疗效与随访6个月后主要心血管不良事件(MACE)发生率;比较两组患者治疗前后肺功能指标[用力肺活量(FVC)、1s用力呼气容积(FEV1)]、外周血T淋巴细胞亚群含量(CD4+、CD4+/CD8+)及血清炎性细胞因子[白细胞介素-10(IL-10)、肿瘤坏死因子-"(TNF-")、白细胞介素-6(IL-6)]水平变化。结果:干预组总有效率为96.67%,显著高于对照组的66.67%(P<0.05)。治疗后,两组患者的肺功能指标、外周血CD4+、CD4+/CD8+,以及血清IL-10水平均较治疗前明显升高(P<0.05),而血清TNF-"、IL-6水平则较治疗前明显降低(P<0.05);且干预组上述各项指标均明显优于对照组(P<0.05)。随访6个月,两组MACE发生率差异无统计学意义(P>0.05)。结论:氨茶碱联合氯雷他定治疗替格瑞洛相关呼吸困难效果良好,能明显缓解患者临床症状,减轻机体炎症反应,调节机体免疫力,且安全性好。

Objective: To explore the therapeutic effect of aminophylline combined with loratadine in the treatment of tegrarol-related dyspnea and the influence on T lymphocyte subsets and inflammatory cytokines in peripheral blood. Methods: Totally 120 patients receiving coronary heart disease treatment and diagnosed with ticagrelor-related dyspnea were randomly divided into intervention group and control group with 60 cases in each group. The intervention group was treated with aminophylline combined with loratadine,while the control group was treated with placebo. The clinical efficacy of the two groups was observed,and the incidence of major adverse cardiovascular events(MACE) was recorded after 6-month follow-up. The lung function indices [forced vital capacity(FVC),1 s forced expiratory volume(FEV1) ],peripheral blood T lymphocyte subsets(CD4+,CD4+/CD8+) and serum inflammatory cytokines were compared between the two groups before and after treatment,and the changes in the levels of IL-10(IL-10),tumor necrosis factor-(TNF-") and interleukin-6(IL-6) were compared as well. Results: The total effective rate of the intervention group was96.67%,which was significantly higher than that(66.67%) of the control group(P<0.05). After treatment,the lung function indices,peripheral blood CD4+ratio,CD4+/CD8+ and the serum IL-10 levels of the two groups were significantly higher than those before treatment(P<0.05),while the serum TNF-α and IL-6 levels were significantly reduced compared with those before treatment(P <0.05);the above indicators of the intervention group were significantly better than those of the control group(P<0.05). After the 6-month follow-up,there was no statistically significant difference in the incidence of MACE between the two groups(P>0.05). Conclusion: Aminophylline combined with loratadine is effective in the treatment of tegrarol-related dyspnea,which can significantly alleviate the clinical symptoms,reduce the inflammatory response and regulate the immune system with good safety.