负荷剂量替格瑞洛对心梗患者PCI后炎性因子、血管内皮功能的影响

目的探讨负荷剂量替格瑞洛对心肌梗死(心梗)患者经皮冠状动脉介入治疗(PCI)后炎性因子及血管内皮功能的影响。方法102例心梗患者,随机分为研究组(58例)与对照组(44例)。PCI术前对照组给予氯吡格雷负荷剂量治疗,研究组给予替格瑞洛负荷剂量治疗。比较两组手术前后的血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和白细胞介素-1β(IL-1β)水平及肱动脉内皮依赖性血管舒张功能(FMD)。结果术后,两组TNF-α、IL-6、IL-1β均高于术前,差异有统计学意义(P<0.05);两组术后血清IL-6水平比较差异无统计学意义(P>0.05);而研究组血清TNF-α(17.49±3.17)ng/L、IL-1β(8.77±2.11)ng/L明显低于对照组的(19.71±4.56)、(10.61±3.14)ng/L,差异有统计学意义(P<0.05)。术后,两组FMD均高于术前,差异有统计学意义(P<0.05);但术后两组FMD比较,差异无统计学意义(P>0.05)。结论负荷剂量替格瑞洛对PCI术后炎性因子的抑制、血管内皮功能的改善作用明确,其中抑炎作用可能较氯吡格雷更强。

Effects of loading dose of ticagrelor on inflammatory factors and vascular endothelial function after PCIin patients with myocardial infarction

Objective To discuss the effect of loading dose of ticagrelor on inflammatory factors,vascular endothelial function and coronary blood flow in patients with myocardial infarction(MI)after percutaneous coronary intervention(PCI).Methods A total of 102 patients with myocardial infarction were randomly divided into research group(58 cases)and control group(44 cases).Before PCI,the control group was given a loading dose of clopidogrel,and the research group was given a loading dose of ticagrelor.The serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-1β(IL-1β)levels and flow-mediated vasodilation(FMD)were compared between the two groups.Results Before operation,the TNF-α,IL-6 and IL-1βof the two groups were higher than those before operation,and the difference was statistically significant(P<0.05).After operation,there was no statistically significant difference in serum IL-6 between the two groups(P>0.05);the serum TNF-α(17.49±3.17)ng/L and IL-1β(8.77±2.11)ng/L of the research group were obviously lower than(19.71±4.56)and(10.61±3.14)ng/L of the control group,and the difference was statistically significant(P<0.05).After operation,the FMD of the two groups was higher than that before operation,and the difference was statistically significant(P<0.05);there was no statistically significant difference in FMD between the two groups(P>0.05).Conclusion Loading dose of ticagrelor can inhibit inflammatory factors,improve vascular endothelial function and coronary blood flow after PCI,and the anti-inflammatory effect may be stronger than clopidogrel.