2019 年第 4 期 第 14 卷

替格瑞洛对老年不稳定型心绞痛患者血清炎性因子及不良心血管事件的影响

Effect of ticagrelor on serum inflammatory factors and adverse cardiovascular events in elderly patients with unstable angina pectoris

作者：曾清泽刘甲兴杨聪德蔡智伟谢显学黄淮滨

英文作者：

单位：362000福建省泉州市，解放军第一八○医院心血管内科

英文单位：

关键词：不稳定型心绞痛；替格瑞洛；氯吡格雷；炎性因子；不良心血管事件

英文关键词：

• 摘要：

• 【摘要】目的    探讨替格瑞洛对老年不稳定型心绞痛（UAP）患者血清炎性因子及不良心血管事件的影响。方法    选取2016年1月至2017年9月在解放军第一八○医院接受治疗的UAP患者96例，根据随机数字表法分为对照组和观察组，各48例。对照组患者在常规治疗基础上采用阿司匹林肠溶片联合氯吡格雷薄膜衣片进行治疗；观察组患者在常规治疗基础上采用阿司匹林肠溶片联合替格瑞洛片进行治疗。比较2组患者的总有效率、每周心绞痛发作次数、每次发作持续时间、血清炎性因子［白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）、高敏C反应蛋白（hs-CRP）］水平、不良心血管事件和不良反应发生率。结果    观察组患者总有效率明显高于对照组［89.6%（43/48）比72.9%（35/48）］，差异有统计学意义（P=0.036）。治疗第12个月，观察组每周心绞痛发作次数及每次发作持续时间均明显少于/短于对照组［（1.6±1.0）次比（2.6±1.1）次、（2.2±1.1）min比（3.5±1.2）min］，差异均有统计学意义（均P＜0.05）。治疗12个月后，观察组血清IL-6、TNF-α、hs-CRP水平均明显低于对照组［（2.1±1.0）ng/L比（3.2±1.0）ng/L、（125±21）μg/L比（185±24）μg/L、（1.2±1.0）mg/L比（2.2±1.0）mg/L］，差异均有统计学意义（均P＜0.05）。2组患者用药期间均未发生心源性死亡、心肌梗死、心力衰竭、缺血性卒中等不良心血管事件。2组患者不良反应发生率比较，差异无统计学意义（P=0.695）。结论    与氯吡格雷相比，替格瑞洛治疗老年UAP患者有更好的临床疗效，可更明显地降低血清炎性因子水平，且2种药物的安全性相当。

• 【Abstract】Objective    To investigate the effect of ticagrelor on serum inflammatory factors and adverse cardiovascular events in elderly patients with unstable angina pectoris(UAP). Methods    A total of 96 patients with UAP admitted to the 180th Hospital of Chinese People′s Liberation Army from January 2016 to September 2017 were enrolled. They were randomly divided into control group and observation group, with 48 cases in each group. The control group took aspirin and clopidogrel. The observation group took aspirin and ticagrelor. Clinical effective rate, times of weekly angina attacks, duration of angina attack, serum inflammatory factors［interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), high-sensitivity C-reactive protein(hs-CRP)］, adverse cardiovascular events and adverse drug reactions were analyzed. Results    The total effective rate in observation group was significantly higher than that in control group［89.6%（43/48） vs 72.9%（35/48）］(P=0.036). During the 12th month of treatment, weekly angina attacks and the duration of angina in observation group were significantly less/shorter than those in control group［（1.6±1.0）times vs （2.6±1.1）times, （2.2±1.1）min vs （3.5±1.2）min］(P＜0.05). Twelve months after treatment, serum levels of IL-6, TNF-α and hs-CRP in observation group were significantly lower than those in control group［（2.1±1.0）ng/L vs （3.2±1.0）ng/L, （125±21）μg/L vs （185±24）μg/L, （1.2±1.0）mg/L vs （2.2±1.0）mg/L］(P＜0.05). No adverse cardiovascular events such as cardiac death, myocardial infarction, heart failure and ischemic stroke were reported. Incidence of adverse reactions showed no significant difference between groups(P=0.695). Conclusion    Compared with clopidogrel, ticagrelor has a better therapeutic effect on UAP in the elderly; ticagrelor can significantly reduce angina attacks and serum inflammatory factors; the safeties of the two drugs are comparable.