氯吡格雷对急性冠脉综合征患者炎性标记物的影响

目的:探讨氯吡格雷对急性冠脉综合征(ACS)患者炎性标记物的影响。方法:入选在我院住院治疗的ACS患者158例,其中不稳定型心绞痛患者67例、非ST段抬高型心肌梗死患者42例、ST段抬高型心肌梗死49例。根据临床用药方式的不同所有患者被分为联合治疗组(80例,氯吡格雷+阿司匹林)和阿司匹林治疗组(78例,阿司匹林),检测两组患者治疗前,治疗后第7、14d血清高敏C-反应蛋白(hsCRP)、P-选择素(P-selec-tin)、白细胞介素-6(IL-6)水平。结果:治疗第7d,两组患者hsCRP、IL-6以及P-选择素均较治疗前显著升高(P<0.05);阿司匹林治疗组上升幅度显著高于联合治疗组(P<0.05);治疗第14d,两组患者上述指标均较治疗前显著降低(P<0.01),与阿司匹林组比较,联合治疗组hsCRP[(3.48±1.98)mg/L比(2.93±1.16)mg/L]、IL-6[(9.81±4.58)μg/L比(8.98±3.52)μg/L]、P-选择素[(9.56±4.67)ng/ml比(9.11±4.57)ng/ml]水平降低更显著(P均<0.05)。两组患者出血情况差异无显著性(P>0.05)。结论:氯吡格雷能显著降低急性冠脉综合征患者炎性标志物水平,这可能是其发挥作用的机制之一。

Influence of clopidogrel on inflammatory markers in patients with acute coronary syndrome

Objective： To investigate influence of clopidogrel on inflammatory markers in patients with acute coronary syndrome （ACS）. Methods： A total of 158 ACS inpatients from our hospital were enrolled, including 67 cases with unstable angina pectoris （UAP）, 42 cases with non-ST elevation myocardial infarction （NSTEMI） and 49 cases with ST elevation myocardial infarction （STEMI）. According to clinical drug treatment, all patients were divided into combined treatment group （n = 80, received elopidogrel and aspirin） and aspirin treatment group （n = 78, only re- ceived aspirin）. Serum levels of high sensitive C reactive protein （hsCRP）, P seleetin and interleukin-6 （IL-6） were measured in two groups before treatment, seven and 14 days after treatment. Results： After seven day treatment, compared with before treatment, levels of hsCRP, IL-6 and P-selectin significantly increased in both groups （P〈 0.05）, and those of aspirin treatment group were significantly higher than those of combined treatment group （P〈 0.05）; after 14 d treatment, compared with before treatment, above indexes significantly decreased in two groups （P〈0.01）, compared with aspirin treatment group, there were significant decrease in levels of hsCRP E （3.48± 1.98） mg/L vs. （2.93± 1.16） mg/L], IL-6 [ （9.81±4.58） μg/L vs. （8.98± 3.52） μg/L] and P-selectin [ （9.56 ±4.67） ng/ml vs. （9.11±4.57） ng/ml] in combined treatment group, P〈0.05 all. There was no significant difference in bleeding between two groups （P〉0.05）. Conclusion： Clopidogrel can significantly decrease levels of inflammatory markers in patients with acute coronary syndrome, which may be one of its effect mechanisms.