摘要
目的:观察氯吡格雷治疗非ST段抬高型急性冠脉综合征(NSTEACS)疗效以及对炎性因子hs-CRP,TNF-α影响.方法:选取NSTEACS患者80例,随机分为观察组和对照组,各40例.对照组首次顿服阿司匹林300mg,而后口服100mg/d.观察组首次顿服阿司匹林和硫酸氢氯吡格雷各300mg,而后口服阿司匹林100mg+硫酸氢氯吡格雷75mg/d.观察两组胸痛症状、心电图及心脏不良事件.分别在用药前、用药后7,30d抽取空腹静脉血,应用散射比浊法和ELISA检测高敏C-反应蛋白(hs-CRP)和肿瘤坏死因子-α(TNF-α)浓度.结果:治疗30d后观察组胸痛症状及心电图的改善情况明显优于对照组(P<0.05);观察组心脏再缺血事件发生率低于对照组.用药后7d,两组患者血清hs-CRP,TNF-α的浓度均降低(P<0.01);用药后30d,两组患者血清hs-CRP,TNF-α的浓度均进一步降低,且观察组hs-CRP和TNF-α的浓度较对照组下降明显(P<0.05).结论:氯吡格雷对NSTEACS具有心血管保护作用,减少心脏事件发生率,并且显著降低炎症因子hs-CRP,TNF-α水平,减轻动脉硬化炎症反应,进而抑制动脉粥样硬化的进展.
AIM： To observe the therapeutic effect of clopidogrel and its influence on blood concentration of hs-CRP and TNF-α in patients with non-ST elevation acute coronary syndrome. METHODS： Eighty patients with non-ST elevation acute coronary syndrome were randomized into 2 groups： Aspirin （control group） and aspirin ＋ elopidogrel （ treatment group ）. Patients in the control group took 300 mg aspirin for the first time, followed by 100 mg aspirin per day, while patients in the treatment group took 300 mg aspirin and 300 mg clopidogrel for the first time, followed by 100 mg aspirin and 75 mg clopidogrel per day. The clinical symptoms and incidence of cardiac event of the 2 groups were observed. The concentrations of hs-CRP and TNF-α were detected in all the patients before as well as 7 and 30 d after the administration of medicine. RESULTS： Compare with those in control group, the clinical symptoms and major cardiac occurrence in treatment group decreased significantly （ P 〈 0.05 ）. Seven days after the administration of medicine, the concentrations of hs-CRP and TNF-α in both groups decreased significantly （ P 〈 0. 01 ）. Thirty days after the administration of medicine, the concentrations further decreased and the concentrations of hs-CRP and TNF-α in treatment group were significantly lower compared with those in control group （ P 〈 0.05 ）. CONCLUSION ： Clopidogrel has some protective effect on the cardiovascular system and reduces the major cardiac occurrence in patients with non-ST elevation acute coronary syndrome. Clopidogrel also alleviates the inflammation of arteries and suppresses the progress of atheroselerosis by reducing the plasma level of hs-CRP and TNF-α, thus improving the prognosis of patients with acute coronary syndrome.
出处
《第四军医大学学报》
北大核心
2009年第11期1020-1022,共3页
Journal of the Fourth Military Medical University
