氯吡格雷在急性冠状动脉综合征中的抗炎作用

目的:观察氯吡格雷在急性冠状动脉综合征(ACS)中的抗炎作用。方法:入选健康对照组30例、稳定型心绞痛(SAP)组40例、ACS患者66例,后者按照治疗方案不同随机、单盲分为氯吡格雷加阿司匹林组(A组)和阿司匹林(B组),观察疗程1周。所有受检者测定入院时血浆高敏C反应蛋白(hs-CRP)和P选择素(Ps)水平,ACS患者治疗1周后复查hs-CRP和Ps。观察各组hs-CRP和Ps的基线状态及治疗后变化情况。结果:药物干预前ACSA、B组患者hs-CRP和Ps较SAP组和健康对照组明显升高(P<0.01)。而SAP组与健康对照组之间,A组和B组之间hs-CRP和Ps差异无统计学意义(P>0.05),干预1周后A组比B组hsCRP和Ps显著降低(P<0.01)。结论:ACS存在明显的炎症过程;氯吡格雷可以下调ACS患者的炎症因子,具有抗炎作用。

Clinical study of anti-inflammatory action of clopidogrel in acute coronary syndrome

Objective:To observe whether clopidogrel has an anti-inflammatory action in patients with acute coronary syndrome(ACS). Method:Thirty healthy control people and 106 patients with coronary atherosclerotic heart disease included 40 patients with stable angina pectoris and 66 patients with ACS were randomly assigned into group A and B to receive combination of clopidogrel and aspirin (n=33) or aspirin alone (n=33) for 7 days. All patients had measurements of high-sensitivity C-reactive protein (hsCRP) concentration and P-selection (Ps) level at base line. The changes of hsCRP and Ps in patients with ACS were assessed after 7 days.Result:The hsCRP concentration and Ps level in patients with ACS were significantly higher than those in patients with stable angina pectoris and healthy control at base line (P<0.01). Combination of clopidogrel and aspirin significantly reduced plasma concentration of hsCRP and platelet Ps expression after 7 days compared with aspirin alone(P<0.01).Conclusion :Inflammatory processes have an important role in ACS. Our results indicate that clopidogrel has beneficial effects on down regulating inflammatory processes except for inhibiting platelet activation.