氯吡格雷联合阿司匹林及低分子肝素钙对心肌梗死患者的有效性及血清MIF、IL-10的影响

Therapeutic effect of clopidogrel combined aspirin and low molecular weight heparin calcium on patients with myocardial infarction and its influence on serum levels of MIF and IL-10

目的:研究氯吡格雷联合阿司匹林及低分子肝素钙对心肌梗死患者的疗效及其对血清巨噬细胞游走抑制因子(MIF)、白介素(IL)-10水平的影响。方法:我院的94例心肌梗死患者被随机均分为阿司匹林组(常规治疗基础上加用阿司匹林联合低分子肝素)和联合治疗组(阿司匹林组基础上加用氯吡格雷)。两组均治疗3个月。观察比较两组治疗前后血清肌酸激酶同工酶(CK-MB)、cTnT、超氧化物歧化酶(SOD)、MIF、IL-10水平及不良心血管事件率。结果:治疗后,与阿司匹林组比较,联合治疗组血清CK-MB[(64.48±5.13)U/L比(45.30±5.34)U/L]、cTnT[(1.11±0.31)U/L比(0.66±0.11)U/L]、MIF[(1.16±0.25)ng/ml比(0.95±0.16)ng/ml]降低更显著,血清SOD[(156.97±10.04)U/L比(176.52±11.49)U/L]、血清IL-10水平[(341.88±30.20)pg/ml比(536.62±27.44)pg/ml]升高更显著,P均=0.001。联合治疗组不良心血管事件率显著低于阿司匹林组(4.26%比51.06%,P=0.001)。结论:氯吡格雷联合阿司匹林及低分子肝素钙可显著改善心肌梗死患者心肌酶及炎症因子水平,安全性好。

Objective:To study therapeutic effect of clopidogrel combined aspirin and low molecular weight heparin calcium(LMWHC)on patients with myocardial infarction and its influence on serum levels of macrophage migration-inhibitory factors(MIF)and interleukin(IL)-10.Methods:A total of 94 patients with myocardial infarction in our hospital were randomly and equally divided into aspirin group(received aspirin combined LMWHC based on routine treatment)and combined treatment group(received clopidogrel based on aspirin group).Both groups were treated for three months.Serum levels of creatine kinase isoenzyme(CK-MB),cTnT,superoxide dismutase(SOD),MIF and IL-10 before and after treatment and incidence rate of adverse cardiovascular events were observed and compared between two groups.Results:Compared with aspirin group after treatment,there were significant reductions in serum levels of CK-MB[(64.48±5.13)U/L vs.(45.30±5.34)U/L],cTnT[(1.11±0.31)U/L vs.(0.66±0.11)U/L]and MIT[(1.16±0.25)ng/ml vs.(0.95±0.16)ng/ml],and significant rise in serum levels of SOD[(156.97±10.04)U/L vs.(176.52±11.49)U/L]and IL-10[(341.88±30.20)pg/ml vs.(536.62±27.44)pg/ml]in combined treatment group,P=0.001 all.Incidence rate of adverse cardiovascular events in combined treatment group was significantly lower than that of aspirin group(4.26%vs.51.06%,P=0.001).Conclusion:Clopidogrel combined aspirin and low molecular weight heparin calcium can significantly improve levels of myocardial enzymes and inflammatory factors with good safety in patients with myocardial infarction.