替格瑞洛对合并糖尿病的不稳定型心绞痛老年患者的治疗效果及对血清炎症因子的影响

Treatment efficacy of oral administration ticagrelor in treating UA with diabetes mellitus elderly patients and its influence on serum inflammatory factors

目的探讨口服替格瑞洛治疗不稳定型心绞痛(UA)合并糖尿病老年患者的治疗效果及对患者血清炎症因子水平的影响。方法选取2015年3月—2017年9月在安国市医院就诊的UA合并2型糖尿病老年患者100例,随机分为观察组(n=50)和对照组(n=50)。对照组在常规基础给予患者口服氯吡格雷片,观察组在常规基础给予患者口服替格瑞洛片,均治疗6个月。对比两组心绞痛发作情况、血清高敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、CD40配体(CD 40L)水平及循环血内皮细胞(CEC)。结果观察组总有效率86.00%,显著高于对照组的总有效率60.00%,差异有统计学意义(P<0.05)。治疗后两组发作频率、发作间隔和发作持续时间与治疗前比较差异均显著(P<0.05);且观察组发作频率和发作持续时间均显著少于对照组(P<0.05),发作间隔显著长于对照组(P<0.05)。治疗后,两组血清hs-CRP、IL-6和外周血CEC均较治疗前显著降低,CD40L水平显著升高(P<0.05);且观察组血清hs-CRP、IL-6水平和外周血CEC较对照组显著降低(P<0.05);两组CD40L水平比较,差异无统计学意义。结论口服替格瑞洛治疗UA合并糖尿病老年患者效果显著,且能降低血清炎症因子水平,值得临床推广。

Objective To investigate the effect of oral administration ticagrelor in treating unstable angina(UA)with diabetes mellitus elderly patients and the level of serum inflammatory factors.Methods 100 elderly patients with UA and 2 diabetes in our hospital from March 2015 to September 2017 and were randomly divided into the observation group(ticagrelor,n=50)and the control group(clopidogrel,n=50).The incidence of angina pectoris,serum hs-CRP,IL-6,CD40 L levels and peripheral blood CEC were compared between the two groups.Results The total effective rate of the observation group was 86.00%(43/50),which was significantly higher than that of the control group 60.00%(30/50)(P<0.05).The frequency,interval and duration of attack in the two groups were significantly different from those before treatment(P<0.05),and the seizure frequency and duration of seizures in the observation group were significantly less than those in the control group(P<0.05),and the interval between the seizures was significantly longer than that of the control group(P<0.05).The levels of serum hs-CRP,IL-6 and CEC in peripheral blood of the observation group were significantly lower than those of the control group(P<0.05).There was no significant difference in the level of CD40 L between the two groups.Conclusion Oral administration ticagrelor in treating UA with diabetes mellitus elderly patients is effective and can reduce the level of serum inflammatory factors.It is worthy of clinical promotion.