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目的观察氯吡格雷对急性冠脉综合征患者支架植入术后高敏C-反应蛋白(hs-CRP)和肿瘤坏死因子(TNF-α)的影响。方法选取82例成功行支架植入术的急性冠脉综合征患者,随机分为观察组50例和对照组32例,观察组患者术后给予阿司匹林和氯吡格雷治疗,对照组术后给予阿司匹林治疗。分别在术后用药前、用药后1周、1月采集外周血检测血清高敏C-反应蛋白(hsC-RP)和肿瘤坏死因子-α(TNF-α)浓度。结果观察组和对照组用药前血清hsC-RP和TNF-α浓度比较差异无统计学意义(P﹥0.05);随着治疗时间延续,炎性因子水平逐渐下降。治疗1周时,两组患者血清hsC-RP和TNF-α的浓度与用药前比较均有所下降,且差异有统计学意义(P﹤0.05),而且观察组血清hsC-RP浓度下降较对照组幅度更加明显,差异有统计学意义(P﹤0.05),但两组TNF-α浓度下降幅度比较差别不大,差异无统计学意义(P﹥0.05)。治疗1月时,两组患者血清hsC-RP和TNF-α的浓度进一步下降,差异有统计学意义(P﹤0.05),且观察组患者血清hsC-RP和TNF-α浓度明显低于对照组,差异有统计学意义(P﹤0.05)。结论氯吡格雷可以通过抑制血小板聚集和降低血清炎性因子作用,对急性冠脉综合征以及支架植入术后再狭窄起到治疗作用。
Objective To observe the effect of clopidogrel on high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor (TNF-α) in patients with acute coronary syndrome after stent implantation. Methods A total of 82 patients with acute coronary syndrome who underwent stent implantation were randomly divided into observation group (50 cases) and control group (32 cases). Patients in the observation group were treated with aspirin and clopidogrel postoperatively, while those in the control group were given aspirin treatment. Serum high-sensitivity C-reactive protein (hsC-RP) and tumor necrosis factor-α (TNF-α) levels were measured in peripheral blood before treatment, 1 week and 1 month after treatment. Results There was no significant difference in serum hsC-RP and TNF-α levels between the observation group and the control group before treatment (P> 0.05). The level of inflammatory cytokines gradually decreased with the prolongation of treatment time. At 1 week after treatment, serum hsC-RP and TNF-α concentrations in both groups decreased compared with those before treatment, and the difference was statistically significant (P <0.05). The serum hsC-RP concentration in the two groups decreased more significantly than that in the control The amplitude of TNF-αdecreased more significantly in the two groups (P <0.05), but there was no significant difference between the two groups (P> 0.05). The levels of hsC-RP and TNF-α in serum of the two groups decreased further at 1 month after treatment, with statistical significance (P <0.05). The concentrations of hsC-RP and TNF-α in the observation group were significantly lower than those in the control group , The difference was statistically significant (P <0.05). Conclusion Clopidogrel may have a therapeutic effect on acute coronary syndrome and restenosis after stent implantation by inhibiting platelet aggregation and decreasing serum inflammatory cytokines.