单药与双联抗血小板治疗对药物洗脱支架植入术后血管内皮功能及炎症因子的影响

doi:10.3969/j.issn.1006-6233.2018.02.014

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摘要 目的: 探讨药物洗脱支架植入术后不同抗血小板治疗方案对血管内皮功能及炎症因子的影响。方法: 将2015年1月至2016年12月于我院行冠脉内药物洗脱支架植入术的冠心病患者300例随机分为单药组和双联组,单药组采用氯吡格雷进行抗血小板治疗,双联组采用氯吡格雷+阿司匹林治疗。比较两组术前、术后12h、术后30d时ET-1、NO等血管内皮功能指标以及TNF-a、IL-1、CRP等炎症因子之间的差异。结果: 患者术后ET-1、TNF-a和CRP水平上升、NO下降;采用抗血小板药物治疗30d后患者ET-1、TNF-a和CRP水平下降,NO上升。对两种治疗方案对比结果显示双联组术后30d时ET-1和CRP水平均小于单药组,且下降幅度大于单药组。此外,虽然双联组术后30d TNF-a水平与单药组相比差异无统计学意义,但其降低幅度比单药组更大(P<0.05)。结论: 氯吡格雷+阿司匹林双联用药组与氯吡格雷单药组对比,能够更好地改善药物洗脱支架植入术后患者的血管内皮功能,降低炎症反应。

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	郭庆
	叶鸿

关键词 ：氯吡格雷, 阿司匹林, 双联, 药物洗脱支架, 内皮功能, 炎症因子

Abstract：Objective: To investigate the effect of different antiplatelet regimens on vascular endothelial function and inflammatory factors after drug-eluting stent implantation. Methods: 300 patients with coronary heart disease and came to our hospital for drug eluting stent implantation from January 2015 to December 2016 were enrolled and randomly divided into monotherapy group and dual antiplatelet therapy group. Monotherapy group receive clopidogrel antiplatelet treatment whereas dual antiplatelet therapy group receive clopidogrel plus aspirin in the treatment. The vascular endothelial function indexes such as ET-1, NO and inflammatory factors such as TNF-a, IL-1, CRP were compared between the two groups at the time before operation, 12 hours after operation and 30 days after operation. Results: After operation, the levels of ET-1, TNF-a and CRP increased significantly, and NO decreased significantly. After 30 days antiplatelet treatment, the levels of ET-1, TNF-a and CRP decreased, and NO increased. Besides, ET-1 and CRP levels in dual antiplatelet therapy group were less than monotherapy group at 30 days after operation and they change more in dual antiplatelet therapy group. Level of TNF-a showed no significant difference between the two group, however, dual antiplatelet therapy group showed greater reductions than monotherapy group (P<0.05). Conclusion: Compared with clopidogrel monotherapy, clopidogrel plus aspirin can improve the vascular endothelial function and reduce the inflammatory reaction in patients after drug-eluting stent implantation.

Key words： Clopidogrel Aspirin Dual antiplatelet Drug-eluting stent Endothelial function Inflammatory factors

通讯作者: 叶鸿

引用本文:

郭庆, 叶鸿. 单药与双联抗血小板治疗对药物洗脱支架植入术后血管内皮功能及炎症因子的影响[J]. 河北医学, 2018, 24(2): 235-239.
GUO Qing, YE Hong. Effects of Monotherapy and Dual Antiplatelet Therapy on Vascular Endothelial Function and Inflammatory Factors after Drug-eluting Stent Implantation. HeBei Med, 2018, 24(2): 235-239.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2018.02.014 或 http://www.hbyxzzs.cn/CN/Y2018/V24/I2/235

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