替格瑞洛与氯吡格雷对急性ST段抬高性心肌梗死患者术后炎症反应和心功能及预后的影响

Effects of ticagrelor and clopidogrel on postoperative inflammatory response,cardiac function and prognosis in patients with acute ST segment elevation myocardial infarction

目的探究替格瑞洛与氯吡格雷对急性ST段抬高性心肌梗死(STEMI)患者术后炎症反应、心功能及预后的影响。方法选取2018年1月至2019年4月本院收治的94例STEMI患者作为研究对象,按照随机数字表法分为两组,每组47例。替格瑞洛组采用阿司匹林+替格瑞洛治疗,氯吡格雷组采用阿司匹林+氯吡格雷治疗,比较两组炎症因子[白细胞介素(IL)-6、IL-10及肿瘤坏死因子-α(TNF-α)]水平、心功能[左心室短轴缩短率(LVFS)、左心室射血分数(LVEF)及心率]和预后情况。结果治疗前,两组IL-6、IL-10及TNF-α水平比较差异无统计学意义;治疗后,两组IL-6及TNF-α水平均低于治疗前,IL-10水平高于治疗前,且替格瑞洛组IL-6及TNF-α水平均低于氯吡格雷组,IL-10水平高于氯吡格雷组,差异有统计学意义(P<0.05)。治疗前,两组LVFS、LVEF、心率比较差异无统计学意义;治疗后,两组LVFS和心率均低于治疗前,LVEF高于治疗前,且替格瑞洛组LVFS和心率均低于氯吡格雷组,LVEF高于氯吡格雷组,差异有统计学意义(P<0.05)。替格瑞洛组不良事件发生率低于氯吡格雷组,差异有统计学意义(P<0.05)。结论与氯吡格雷比较,替格瑞洛在控制STEMI术后患者炎症反应、改善心功能方面效果显著,且可明显改善患者预后。

Objective To investigate the effects of ticagrelor and clopidogrel on postoperative inflammatory response,cardiac function and prognosis in patients with acute ST segment elevation myocardial infarction(STEMI).Methods 94 patients with STEMI admitted to our hospital from January 2018 to April 2019 were selected as the research subjects,and they were divided into two groups according to the random number table method,with 47 cases in each group.The ticagrelor group was treated with aspirin+ticagrelor,and the clopidogrel group was treated with aspirin+clopidogrel,the levels of inflammatory factors(interleukin[IL]-6,IL-10 and tumor necrosis factor-α[TNF-α]),cardiac function[left ventricular fraction shortening(LVFS),left ventricle ejection fraction(LVEF)and heart rate]and prognosis were compared between the two groups.Results Before treatment,there were no significant differences in IL-6,IL-10 and TNF-αlevels between the two groups;after treatment,the levels of IL-6 and TNF-αof two groups were lower than before treatment,the levels of IL-10 were higher than before treatment,and the levels of IL-6 and TNF-αin the ticagrelor group were lower than the clopidogrel group,and the levels of IL-10 were higher than the clopidogrel group,the differences were statistically significant(P<0.05).Before treatment,there was no significant difference in LVFS,LVEF and heart rate between the two groups;after treatment,LVFS and heart rate of two groups were lower than before treatment,LVEF was higher than before treatment,and LVFS and heart rate in the ticagrelor group were lower than the clopidogrel group,LVEF was higher than the clopidogrel group,the differences were statistically significant(P<0.05).The incidence of adverse events in ticagrelor group was lower than the clopidogrel group,and the difference was statistically significant(P<0.05).Conclusion Compared with clopidogrel,ticagrelor was significantly effective in controlling inflammation and improving cardiac function after STEMI,and significantly improved outcomes.