替格瑞洛与氯吡格雷对STEMI患者炎症水平及预后的疗效比较
摘要
目的探讨替格瑞洛与氯吡格雷对急性ST段抬高型心肌梗死(STEMI)患者高敏C反应蛋白(hs-CRP),白细胞介素(IL-37),内皮细胞特异性分子1(ESM-1)及短期预后的影响。方法入选行经皮冠状动脉介入治疗(PCI)的急性STEMI患者120例,按PCI术后给药不同将患者分为替格瑞洛组(n=63)和氯吡格雷组(n=57),观察两组治疗前后hs-CRP、ESM-1和IL-37水平变化,以及出院后1个月两组心血管及出血事件的发生情况。结果服药72 h后,替格瑞洛组患者血清hs-CRP、ESM-1和IL-37水平均显著下降(P<0.05),氯吡格雷组仅hs-CRP和IL-37水平显著下降(P<0.05),而ESM-1水平无显著变化(P>0.05),替格瑞洛组血清hs-CRP、ESM-1和IL-37水平显著低于氯吡格雷组(P<0.05)。两组心血管事件、出血事件以及总不良事件发生率均无统计学差异(P>0.05)。结论替格瑞洛可降低急性STEMI患者PCI术后炎症水平,改善患者内皮血管功能,值得临床推荐使用。
引文
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[2]张阳阳,陈魁.替格瑞洛与氯吡格雷对急性STEMI患者急诊PCI术后炎症因子的影响[J].医学与哲学,2014(18):31-32,52.
[3]李世英,柳景华.欧美出血学术研究会(BARC)关于出血的统一定义[J].中国介入心脏病学杂志,2012,20(4):231-234.
[4]Wallentin L,Becker RC,Budaj A,et al.Ticagrelor versus clopidogrel in patients with acute coronary syndromes[J].N Engl J Med,2009,361(11):1045-1057.
[5]Nishida H,Horio T,Suzuki Y,et al.Interleukin-6 as an independent predictor of future cardiovascular events in high-risk Japanese patients:comparison with C-reactive protein[J].Cytokine,2011,53(3):342-346.
[6]Ridker PM,Rifai N,Pfeffer M,et al.Elevation of tumor necrosis factor-alpha and increased risk of recurrent coronary events after myocardial infarction[J].Circulation,2000,101(18):2149-2153.
[7]Libby P,Nahrendorf M,Pittet MJ,et al.Diversity of denizens of the atherosclerotic plaque:not all monocytes are created equal[J].Circulation,2008,117(25):3168-3170.
[8]Shaoyuan C,Ming D,Yulang H,et al.Increased IL-37 in Atherosclerotic disease could be suppressed by atorvastatin therapy[J].Scand J Immunol,2015,82(4):328-336.
[9]Liu K,Tang Q,Zhu X,et al.IL-37 increased in patients with acute coronary syndrome and associated with a worse clinical outcome after ST-segment elevation acute myocardial infarction[J].Clin Chim Acta,2017,468:140-144.
[10]Arpaci D,Karakece E,Tocoglu AG,et al.Endocan,TGF-beta,and ADMA as risk factors for endothelial dysfunction and possible vascular disease in patients with subclinical hypothyroidism[J].Ann Clin Lab Sci,2016,46(6):601-607.
[11]Kose M,Emet S,Akpinar TS,et al.Serum endocan level and the severity of coronary artery disease:a pilot study[J].Angiology,2015,66(8):727-731.
[12]Bechard D,Scherpereel A,Hammad H,et al.Human endothelial-cell specific molecule-1 binds directly to the integrin CD11a/CD18(LFA-1)and blocks binding to intercellular adhesion molecule-1[J].J Immunol,2001,167(6):3099-3106.