氯吡格雷联合阿司匹林治疗老年急性心肌梗死的疗效分析  

Therapeutic effects of clopidogrel combined with aspirin on acute heart infarction in the elderly

作　　者：周伟伟[1] 谷惠敏[1] 吕晓蕾[1] 冯振勤[1] 李相权[1] ZHOU Weiwei;GU Huimin;LV Xiaolei(Department of Cardiology,Kunshan Hospital Affiliated to Jiangsu University,Jiangsu,Kunshan 215300,China)

机构地区：[1]江苏大学附属昆山医院心血管内科,江苏省昆山市215300

出　　处：《河北医药》2018年第14期2186-2188,2192,共4页Hebei Medical Journal

摘　　要：目的研究氯吡格雷联合阿司匹林治疗老年急性心肌梗死的效果及机制。方法老年急性心肌梗死患者180例随机分为氯吡格雷治疗组和氯吡格雷联合阿司匹林治疗组,每组90例,选取同期健康体检者100例作为对照组,观察2组治疗后治愈率,观察2治疗组治疗前后及对照组RhoA/ROCK蛋白表达(RhoA、ROCK1、ROCK2)、心肌肌钙蛋白、C-反应蛋白、脑钠肽(NT-proBNP)、炎性反应因子[白介素(IL-2、IL-3、IL-6、IL-10)]、Klotho、缝隙连接蛋白(CX40、CX43)水平。结果氯吡格雷联合阿司匹林治疗组能有效治疗老年急性心肌梗死,且有效率明显高于氯吡格雷治疗组患者(P<0.05);氯吡格雷联合阿司匹林治疗组治疗后老年急性心肌梗死后患者血清中RhoA、ROCK1、ROCK2、白细胞介素蛋白、心肌肌钙蛋白、C-反应蛋白和NT-proBNP及Klotho蛋白水平明显降低,而CX40和CX43蛋白水平明显升高,且与对照组和氯吡格雷治疗组比较差异有统计学意义(P<0.05)。结论氯吡格雷联合阿司匹林对老年急性心肌梗死有较好的治疗效果,可能与其调控患者体内异常的RhoA/ROCK通路蛋白和炎性反应有关。Objective To investigate the therapeutic effects and action mechanism of clopidogrel combined with aspirin on acute heart infarction in the elderly.Methods A total of 180 elderly patients with acute heart infarction who were admitted and treated in our hospital from October 2010 to December 2015 were randomly divided into clopidogrel treatment group and combination treatment group(clopidogrel+aspirin),with 90 patients in each group.The therapeutic effects,the serum levels of RhoA,ROCK1/2,cardiac troponin,CRP,NT-proBNP,inflammatory reaction factors including IL-2,IL-3,IL-6,IL-10,Klotho and gap connexins(CX40,CX43)before and after treatment were observed and compared between two groups.Results The effective rate in combination treatment group was significantly higher than that in clopidogrel treatment group(P<0.05).After treatment the serum levels of RhoA,ROCK1/2,interleukins,cardiac troponin,CRP,NT-proBNP and Klotho in combination treatment group were significantly decreased,however,the levels of connexin 40 and connnexin 43 were significantly increased,moreover,there were significant differences between the two groups(P<0.05).Conclusion Clopidogrel combined aspirin is effective in treating acute heart infarction in elderly patients,and its action mechanism may be related with the regulation of abnormal RhoA/ROCK pathway proteins and inflammatory reactions.

关 键 词：氯吡格雷 阿司匹林 急性心肌梗死 缝隙连接蛋白 RhoA/ROCK通路 脑钠肽 

分 类 号：R542.22[医药卫生—心血管疾病]