替格瑞洛对PCI术后急性冠脉综合征患者血尿酸影响及其抗炎效应

发布时间：2018-11-15 23:41

【摘要】：目的:研究经皮冠状动脉介入治疗(PCI)术后急性冠脉综合征(ACS)患者替格瑞洛治疗后血尿酸(SUA)变化及其对炎症因子的影响,并与氯吡格雷比较,探讨替格瑞洛抗炎效应。方法:行PCI术后ACS患者162例,随机均分为氯吡格雷对照组和替格瑞洛治疗组(每组各81例),每组均连续用药3个月,比较分析2组治疗前后SUA、炎症因子如超敏C-反应蛋白(hsCRP)、白细胞介素-6(IL-6)和可溶性CD40配体(sCD40L)水平;与基线SUA水平比较,根据治疗后SUA变化,2组再各分为SUA升高组和SUA降低组,分析SUA与炎症因子相关性及SUA变化对炎症因子的影响。结果:氯吡格雷对照组治疗前后SUA水平变化无统计学意义(P0.05),而治疗后替格瑞洛治疗组的SUA水平较基线显著增高(P0.05);两组炎症因子水平均较治疗前明显改善(P0.05),且与氯吡格雷对照组相比,替格瑞洛治疗组炎症因子水平改善更显著(P0.05);氯吡格雷对照组中SUA升高组与SUA降低组炎症因子水平变化无统计学意义(P0.05),而替格瑞洛治疗组治疗后,SUA与炎症因子显著正性相关,SUA升高组炎症因子水平均较SUA降低组显著增高(P0.05)。结论:PCI术后ACS患者替格瑞洛治疗后SUA增高明显,高水平SUA可能促进炎症因子产生,但其炎症因子水平改善作用比氯吡格雷更显著,提示替格瑞洛较氯吡格雷的抗炎作用明显增强,高水平SUA对炎症因子的影响可能不足以抵消其本身较强的抗炎效应。
[Abstract]:Objective: to study the changes of serum uric acid (SUA) and its effect on inflammatory factors in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI), and compare with clopidogrel. To investigate the anti-inflammatory effect of tigrillo. Methods: 162 patients with ACS after PCI were randomly divided into two groups: clopidogrel control group and tigrilol treatment group (81 cases in each group). SUA, was compared before and after treatment in each group for 3 months. The levels of inflammatory factors such as (hsCRP), interleukin-6 (IL-6) and soluble CD40 ligand (sCD40L) were detected. Compared with baseline SUA, according to the changes of SUA after treatment, the two groups were divided into two groups: the SUA increased group and the SUA decreased group. The correlation between SUA and inflammatory factors and the effect of SUA changes on the inflammatory factors were analyzed. Results: there was no significant change of SUA level in clopidogrel control group before and after treatment (P0.05), but the SUA level of tigrilol group was significantly higher than that of baseline group (P0.05). Compared with clopidogrel control group, the level of inflammatory factors in tigrello group was significantly improved (P0.05). In clopidogrel control group, there was no significant difference in the level of inflammatory factors between the elevated SUA group and the decreased SUA group (P0.05). However, after treatment with tigrilol, SUA was positively correlated with inflammatory factors. The level of inflammatory cytokines in SUA increased significantly compared with that in SUA group (P 0.05). Conclusion: the level of SUA in patients with ACS after PCI is significantly higher than that of clopidogrel. The high level of SUA may promote the production of inflammatory factors, but the effect of improving the level of inflammatory factors is more significant than that of clopidogrel. The results suggest that tigrilol has stronger anti-inflammatory effect than clopidogrel, and the effect of high level of SUA on inflammatory factors may not be enough to counteract its strong anti-inflammatory effect.
【作者单位】：运城护理职业学院临床部;山西医科大学第二医院心内科;
【分类号】：R541.4

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