替格瑞洛对NSTE-ACS合并T2DM患者早期PCI围术期唾液酸水平及心功能的影响

Effects of Ticagrelor on Perioperative Sialic Acid and Heart Functiion of Diabetic Patients Complicated with Non-ST-elevation Acute Coronary Syndrome Receiving Perioperative-early Percutaneous Coronary Intervention

【目的】探讨替格瑞洛对早期行经皮冠状动脉支架植入术(PCI)治疗的非ST段抬高型急性冠脉综合征(NSTE-ACS)合并2型糖尿病(T2DM)患者围术期唾液酸(SA)水平及心功能的影响。【方法】选取2019年1月至2021年7月湖南省脑科医院(湖南省第二人民医院)及耒阳市人民医院收治的200例NSTE-ACS合并T2DM患者,所有患者入院48h内行PCI治疗,根据随机数字表法将其分为观察组(口服替格瑞洛)和对照组(口服氯吡格雷),每组100例。比较两组患者术前及术后6h、24h、3d、7d血清SA水平,并比较两组患者术前、术后1周左室射血分数(LVEF)、左室舒张末内径(LVDd)、左室舒张末容积(LVEDV)。【结果】与术前比较,两组术后6h血清SA水平升高,两组术后24h、3d、7d血清SA水平均下降,差异有统计学意义(P<0.05);观察组术后6h、24h、3d、7d血清SA水平均低于对照组,差异有统计学意义(P<0.05)。术后7d,两组患者LVDd、LVEDV均低于术前,LVEF高于术前,但观察组与对照组比较,差异有统计学意义(P<0.05)。【结论】替格瑞洛和氯吡格雷均可降低NSTE-ACS合并T2DM患者PCI术后血清SA水平,并改善左心功能,且替格瑞洛作用优于氯吡格雷。

【Objective】To investigate the effects of ticagrelor on the level of sialic acid(SA)and heart function of non-ST-elevation acute coronary syndrome(NSTE-ACS)complicated with type 2 diabetic mellitus(T2DM)patients while receiving perioperative-early percutaneous coronary intervention(PCI).【Methods】A total of 200 T2DM diabetic patients complicated with non-ST-elevation acute coronary syndrome who were hospitalized and underwent early PCI in Hunan Province's Brain Hospital and People's Hospital of Leiyang from January 2019 to July 2021 were recruited in the study.They were divided into two groups in random,the observation group(with ticagrelor,n=100)and the control group(with clopidogrel,n=100).The serum SA levels were compared between the two groups before operation and postoperation(6 h,24 h,3 d and 7 d).The left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVDd)and left ventricular end-diastolic volume(LVEDV)were compared between the two groups before operation and 1 week after surgery.【Results】The levels of SA in two groups were not significantly different before operation(P>0.05),while postoperative 6 h,the levels were higher than those before operation(P<0.05),then SA levels at 24 h,3 d and 7 d after operation decreased in both groups.The difference was statistically significant(P<0.05).The levels of serum SA in the observation group at 6 h,24 h,3 d,and 7 d after operation were lower than those in the control group,the differences were statistically significant(P<0.05).On the 7th day after operation,the LVDd and LVEDV of the two groups were lower than those before operation,while the LVEF was higher than that before operation.The difference between the observation group and the control group was statistically significant(P<0.05).【Conclusion】Both ticagrelor and clopidogrel can effectively down-regulate SA and improve heart function of NSTE-TCS patients complicated with T2DM after PCI.The efficacy of ticagrelor was better than clopidogrel.