氯吡格雷对急性冠脉综合征PCI术后血清炎症因子影响.docVIP

氯吡格雷对急性冠脉综合征PCI术后血清炎症因子的影响 　　作者：梁孙英，邓 珍，张 明 作者单位：(广东省茂名石化医院综合内科，广东茂名 52500 　　【摘要】 目的 观察氯吡格雷对急性冠脉综合征PCI术后血清炎症因子的影响。方法 46例急性冠脉综合征患者在服用氯吡格雷前(A组)、服用氯吡格雷后PCI术前(B组)、术后第1天(C组)、术后第7天(D组)，采用ELISA测定血清白介素6(IL6)、高敏C反应蛋白(hsCRP)、P选择素(Ps)水平。结果 B组中IL6和Ps水平明显低于A组(P0.05或0.01)，C组中IL6、hsCRP、Ps水平明显高于B组和D组(P0.01)。结论 氯吡格雷可降低急性冠脉综合征患者PCI术后血清炎症因子水平，从而抑制动脉粥样硬化的进展。 　　【关键词】 氯吡格雷;急性冠状动脉综合征;白介素6;高敏C反应蛋白;P选择素 　　Effect of clopidogrel on serum inflammatory factors in patients with acute coronary syndrome after percutaneous coronary intervention 　　LIANG Sunying, DENG Zheng, ZHANG Ming (Department of Integrated Medicine, Maoming Petrochemical Staff Hospital, Guangdong 525000, China) 　　Abstract: Objective To observe the effect of clopidogrel on serum inflammatory factors in patients with acute coronary syndrome (ACS)before and after percutaneous coronary intervention (PCI). Methods Fortysix ACS patients were treated with oral clopidogrel and PCI, and their serum contents of IL6, hsCRP and Pselectin were determined by ELISA before (group A)and after oral clopidogrel including before PCI (group B), and 1 d (group C)and 7 d (group D)after PCI.Results Serum levels of IL6 and Pselectin in group B were significantly lower than those in group A (P0.01 or 0.05), while those of IL6, hsCRP and Pselectin in group C were substantially higher than those in groups B and D (P0.01). Conclusion Clopidogrel can reduce the serum levels of inflammatory factors in ACS patients after PCI, which may prevent the progression of atherosclerosis. 　　Key words: clopidogrel; acute coronary syndrome; IL6; hsCRP;PSelectin 　　目前的观点认为冠心病(chronic heart disease，CHD)是有免疫系统参与的慢性炎症反应[1]。急性冠脉综合征(acute coronary syndrome，ACS)是冠心病急症，是由于冠状动脉粥样硬化斑块破裂、溃疡、血栓形成，并导致冠状动脉血流减少所引起的一系列临床综合征，炎症参与动脉粥样硬化斑块的形成和破裂，对ACS的发生发展起着重要作用[2]。氯吡格雷是一种新型抗血小板药物，其抗动脉血栓的作用已被大量试验证实，本研究通过对ACS患者PCI术前后常规用药的基础上应用氯吡格雷，通过检测ACS患者血清白介素6(IL6)、高敏C反应蛋白(hsCRP)、P选择素(Pselectin,Ps)的水平，以探讨氯吡格雷对ACS患者血清炎症因子的影响。 　　1 资料与方法 　　1.1 研究对象