目的:本研究旨在觀察PCI術(shù)后急性冠脈綜合征合并糖尿病患者,替格瑞洛及氯吡格雷對(duì)于炎性細(xì)胞因子及血管內(nèi)皮功能的影響。方法:本試驗(yàn)收集了從2017年9月至2019年1月份就診于河北醫(yī)科大學(xué)第二醫(yī)院東院區(qū)心內(nèi)一科,行經(jīng)皮冠脈介入治療術(shù)的急性冠脈綜合征合并糖尿病患者共100名,其中試驗(yàn)組(替格瑞洛組)48名患者,服用替格瑞洛(負(fù)荷劑量為180mg,維持劑量為90mg日二次口服)。對(duì)照組(氯吡格雷組)52名患者,服用氯吡格雷(負(fù)荷劑量300mg,維持劑量為75mg日一次口服),入院用藥前檢測(cè)超敏C反應(yīng)蛋白、白介素-6水平,并行肱動(dòng)脈反應(yīng)性充血試驗(yàn)(左側(cè))及雙下肢踝肱指數(shù)檢查,之后行PCI治療。用藥4周,復(fù)查超敏C反應(yīng)蛋白、白介素-6、反應(yīng)性充血試驗(yàn)及踝肱指數(shù)水平,并比較兩組有無統(tǒng)計(jì)學(xué)差異。結(jié)果:基線資料及用藥前各項(xiàng)數(shù)據(jù)無統(tǒng)計(jì)學(xué)差異,用藥4周,替格瑞洛組的白介素-6水平較氯吡格雷組顯著降低(6.27(4.73,9.05)mg/L vs 8.48(6.80,11.87)mg/L,P=0.002);超敏C反應(yīng)蛋白水平,替格瑞洛組及氯吡格雷組比較差異無顯著性(3.35(1.93,6.80)pg/ml vs 3.20(1.72,6.70)pg/ml,P=0.887);反應(yīng)性充血試驗(yàn)中替格瑞洛組顯示的左側(cè)肱動(dòng)脈血管直徑變化較氯吡格雷組顯著增加(0.40(0.30,0.50)mm vs 0.20(0.20,0.30)mm,P=0.000);而踝肱指數(shù),二組無顯著性差異(左側(cè)1.00(0.94,1.12)vs 1.00(0.92,1.21),P=0.64,右側(cè)1.00(0.90,1.19)vs 0.99(0.91,1.18),P=0.237)。結(jié)論:對(duì)于PCI術(shù)后的急性冠脈綜合征合并糖尿病患者,替格瑞洛較氯吡格雷具有更顯著的抗炎及改善血管內(nèi)皮功能的作用。
【學(xué)位單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位年份】：2019
【中圖分類】：R541.4;R587.2
【部分圖文】：

圖 1 血管直徑變化情況Fig.1 Change of blood vessel diameterControl, clopidogrel; Treatment, ticagrelor; w, weeksNo significant difference of the diameter change of the blood vessel inthe baseline data between two groups. after 4 weeks administration, Theticagrelor group showed higher blood vessel diameter changes than theclopidogrel group. The stata were compared before and after treatment. Thevascular diameter change of the ticagrelor group was also significantlyimproved after administration. But no difference was shown in clopidogrelgroup.

圖 1 血管直徑變化情況Fig.1 Change of blood vessel diameterControl, clopidogrel; Treatment, ticagrelor; w, weeksNo significant difference of the diameter change of the blood vessel inthe baseline data between two groups. after 4 weeks administration, Theticagrelor group showed higher blood vessel diameter changes than theclopidogrel group. The stata were compared before and after treatment. Thevascular diameter change of the ticagrelor group was also significantlyimproved after administration. But no difference was shown in clopidogrelgroup.

圖 3 左側(cè)踝肱指數(shù)情況Fig.3 Distribution of L-ABINone of the data showed significant differences.圖 4 右側(cè)踝肱指數(shù)情況Fig.4 Distribution of R-ABINone of the data showed significant differences.

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 沈云峰;胡遠(yuǎn)貴;張洪波;;血清炎性因子水平與冠狀動(dòng)脈病變程度的相關(guān)性研究[J];海南醫(yī)學(xué);2014年20期

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