摘要
目的：比较替格瑞洛与氯吡格雷对急性冠脉综合征（ACS）患经皮冠状动脉介入治疗（PCI）术后血小板功能和炎性因子的影响。方法选取180例ACS并接受PCI手术治疗的患者，将其按照随机数字表法分为观察组和对照组，每组90例，两组患者均给予常规治疗，对照组在常规治疗基础上术前、术后均给予氯吡格雷进行治疗，观察组在常规治疗基础上术前、术后均给予替格瑞洛进行治疗，分别比较治疗前及术后24 h、7 d、28 d的C-反应蛋白（CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、髓过氧化物酶（MPO）、可溶性CD40受体（sCD40L）含量及血小板最大聚集率（MPAR）、P2Y12反应单位（PRU）；并对术后6个月的主要不良心脑血管事件进行随访。结果两组治疗前MPAR及PRU差异均无统计学意义（t＝0．41、0．19，均P＞0．05）；术后24 h、7 d、28 d两组MPAR及PRU 均较治疗前显著下降（t≥2．09，均P＜0．05）；术后24 h、7 d、28 d观察组MPAR分别为（53．24±11．20）％、（42．33±10．80）％、（30．77±8．99）％，均显著低于对照组的（57．34±13．21）％、（48．09±10．90）％、（38．87±8．97）％（t＝2．24、3．56、6．05，均P＜0．05）；术后24 h、7 d、28 d观察组PRU分别为（214．56±13．45）U、（190．57±12．21）U、（113．26±10．90）U，均显著低于对照组的（225．59±14．78）U、（210．21±14．09）U、（143．23±12．01）U（t＝5．24、2．11、17．53，均P＜0．05）。治疗前两组CRP、sCD40L、IL-6、TNF-α差异均无统计学意义（均P＞0．05）。术后24 h两组CRP、sCD40L、IL-6、TNF-α均较治疗前显著上升（t＝60．79、50．30、27．95、12．98、40．29、16．73、15．03、7．30，均P＜0.05），随后下降，其中观察组术后24 h、7 d、28 d CRP、sCD40L、IL-6、TNF-α均显著性低于对照组（均P＜0．05）。观察组心血管不良事件
Objective To compare the effect of ticagrelor and clopidogrel on platelet functions and inflamma-tion factor in patients with acute coronary syndrome（ACS）after PCI.Methods 180 patients with ACS who taken PCI were chosen and randomly divided into the observation group and the control group（90 cases in each group）.All patients of the two groups were given conventional treatment,and the control group received clopidogrel treatment on the basis of routine therapy preoperation and postoperation,while the observation group received clopidogrel treatment on the basis of the control group treatment.Before treatment and 24 h,7 d,28 d after treatment,the C-reactive protein （CRP）,interleukin 6（IL-6）,tumor necrosis factor alpha（TNF-α）,myeloperoxidase（MPO）,soluble CD40 receptor （sCD40L）,platelet maximum aggregation rate（MPAR）and P2Y12 response unit（PRU）in the two groups were recorded and compared,as well as the main cerebrovascular events after six months follow-up.Results In the two groups before treatment,MPAR and PRU had no statistically significant differences（t=0.41,0.19,all P〉0.05）. 24h,7d and 28d after operation,MPAR and PRU were significantly decreased compared with before treatment（t≥2.09,all P〈0.05）.MPAR in the observation group were （53.24 ±11.20）%,（42.33 ±10.80）%,（30.77 ± 8.99）% respectively,which were significantly lower than those in the control group[（57.34 ±13.21）%,（48.09 ±＆amp;nbsp;10.90）%,（38.87 ±8.97）%]（t=2.24,3.56,6.05,all P〈0.05）.24h,7d and 28d after operation,PRU in the observation group were （214.56 ±13.45）U,（190.57 ±12.21）U,（113.26 ±10.90）U respectively,which were significantly lower than those in the control group[（225.59 ±14.78）U,（210.21 ±14.09）U,（143.23 ±12.01）U] （t=5.24,2.11,17.53,all P〈0.05）.In the two groups before treatment,CRP CD40L,IL-6 and TNF-αhad no statistically significant differences（all P〉0.05 ）.24h after treatment,CRP,sCD40L,IL-6 and TNF-αin the two group
出处
《中国基层医药》
CAS
2017年第3期439-443,共5页
Chinese Journal of Primary Medicine and Pharmacy
