替格瑞洛對PCI術(shù)后ACS合并糖尿病患者炎性細胞因子及血管內(nèi)皮功能的影響
發(fā)布時間：2020-09-10 10:15
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于炎性細胞因子及血管內(nèi)皮功能的影響。方法:本試驗收集了從2017年9月至2019年1月份就診于河北醫(yī)科大學第二醫(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,其中試驗組(替格瑞洛組)48名患者,服用替格瑞洛(負荷劑量為180mg,維持劑量為90mg日二次口服)。對照組(氯吡格雷組)52名患者,服用氯吡格雷(負荷劑量300mg,維持劑量為75mg日一次口服),入院用藥前檢測超敏C反應(yīng)蛋白、白介素-6水平,并行肱動脈反應(yīng)性充血試驗(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)性充血試驗及踝肱指數(shù)水平,并比較兩組有無統(tǒng)計學差異。結(jié)果:基線資料及用藥前各項數(shù)據(jù)無統(tǒng)計學差異,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)性充血試驗中替格瑞洛組顯示的左側(cè)肱動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。
【學位單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位年份】：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.
本文編號：2815703
【學位單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位年份】：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】
相關(guān)期刊論文 前1條
1 沈云峰;胡遠貴;張洪波;;血清炎性因子水平與冠狀動脈病變程度的相關(guān)性研究[J];海南醫(yī)學;2014年20期
本文編號：2815703
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