文章摘要
于海荣,王国宏,董丹丹,姜玉连,杨青苗.替格瑞洛与氯吡格雷对急性心肌梗死患者介入治疗后的心功能和炎症反应的影响[J].,2019,19(2):266-269
替格瑞洛与氯吡格雷对急性心肌梗死患者介入治疗后的心功能和炎症反应的影响
Effects of the Treatment of Cardiac Function and Inflammatory Response in Patients with Acute Myocardial Infarction after Interventional Therapy with the Combination of Ticagrelor and Clopidogrel
投稿时间:2018-07-07  修订日期:2018-07-31
DOI:10.13241/j.cnki.pmb.2019.02.014
中文关键词: 替格瑞洛  氯吡格雷  急性  心肌梗死  介入治疗  心功能  炎症反应
英文关键词: Ticagrelor  Clopidogrel  Acute myocardial infarction  Interventional therapy  Cardiac function  Inflammatory response
基金项目:首都卫生发展科研专项重点攻关项目(201626057)
作者单位E-mail
于海荣 首都医科大学附属北京同仁医院心血管中心 北京 100730 hadrfv@163.com 
王国宏 首都医科大学附属北京同仁医院心血管中心 北京 100730  
董丹丹 首都医科大学附属北京同仁医院心血管中心 北京 100730  
姜玉连 首都医科大学附属北京同仁医院心血管中心 北京 100730  
杨青苗 首都医科大学附属北京同仁医院心血管中心 北京 100730  
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中文摘要:
      摘要 目的:探讨替格瑞洛与氯吡格雷对急性心肌梗死患者介入治疗后的心功能和炎症反应的影响。方法:选取2015年1月-2018年1月期间我院收治的行介入治疗的急性心肌梗死患者300例为研究对象。根据随机数字表法将患者分为替格瑞洛组(n=150)和氯吡格雷组(n=150),其中替格瑞洛组给予阿司匹林、替格瑞洛治疗,氯吡格雷组给予阿司匹林、氯吡格雷治疗。比较两组患者治疗前后的左心室射血分数(LVEF)、左心室舒张末期内径(LVEDd)及白介素-6(IL-6)、C反应蛋白(CRP)、可溶性CD40配体(sCD40L)、肿瘤坏死因子-α(TNF-α)水平,随访3个月,观察两组患者随访期间心血管不良事件的发生情况。结果:两组患者治疗后LVEF较治疗前升高,且替格瑞洛组高于氯吡格雷组,LVEDd较治疗前降低,且替格瑞洛组低于氯吡格雷组(P<0.05)。两组患者治疗后IL-6、CRP、sCD40L、TNF-α均较治疗前升高,但替格瑞洛组低于氯吡格雷组(P<0.05)。替格瑞洛组随访期间心血管不良事件总发生率为10.00%(15/150),显著低于氯吡格雷组患者的31.33%(47/150),组间比较差异有统计学意义(P<0.05)。结论:相较于氯吡格雷而言,替格瑞洛治疗行介入治疗的急性心肌梗死患者效果满意,可显著改善心功能,降低炎症因子水平及心血管不良事件发生率。
英文摘要:
      ABSTRACT Objective: To investigate the effects of the treatment of cardiac function and inflammatory response in patients with acute myocardial infarction after interventional therapy with the combination of ticagrelor and clopidogrel. Methods: a total of 300 patients with acute myocardial infarction who underwent interventional therapy in our hospital from January 2015 to January 2018 were selected as the subjects. The patients were randomly divided into ticagrelor group (n=150) and clopidogrel group (n=150) according to the table method, in which the ticagrelor group were treated with aspirin and ticagrelor, and the clopidogrel group was treated with aspirin and clopidogrel. The cardiac function index [left ventricular ejection fraction (LVEF), left ventricular end diastolic radius (LVEDd)], inflam- matory factor index [interleukins -6(IL-6), C reactive protein(CRP), soluble CD40 ligand(sCD40L) and tumor necrosis factor-α (TNF-α)] were compared between the two groups. 3 months of follow-up, the occurrence of adverse cardiovascular events. Results: LVEF was higher after treatment than that before treatment in the two groups, and the ticagrelor group was higher than that of the clopidogrel group. The LVEDd was lower than that before treatment, and ticagrelor group was lower that of than the clopidogrel group (P<0.05). The IL-6, CRP, sCD40L and TNF-α of the two groups increased after treatment, but the ticagrelor group was lower than that of clopidogrel group(P<0.05). The total incidence of adverse cardiovascular events was 10.00% (15/150) during the follow-up period in the group of the tica- grelor group group, which was significantly lower than that of the patients in the clopidogrel group 31.33% (47/150), there was a signifi- cant difference between the groups(P<0.05). Conclusion: Compared with clopidogrel, the effect of di greold in patients with acute myo- cardial infarction is satisfactory. It can significantly improve the cardiac function, reduce the level of inflammatory factors and reduce the incidence of adverse cardiovascular events.
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