阿司匹林联合替格瑞洛对心肌梗死患者GDF15水平的影响  

Effect of aspirin and ticagrelor on plasma GDF15 level in patients with myocardial infarction

作　　者：姚骞[1] 刘昶[2] 严浩[1] YAO Qian;LIU Chang;YAN Hao(Emergency Department,Beijing Emergency Medical Center,Beijing 100073;Emergency Department,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]北京急救中心急救科,北京100073 [2]首都医科大学附属北京友谊医院急诊科,北京100050

出　　处：《热带医学杂志》2020年第11期1496-1498,1532,共4页Journal of Tropical Medicine

基　　金：北京市科技计划项目(D0905002000011)。

摘　　要：目的探讨阿司匹林联合替格瑞洛在心肌梗死患者中的临床效果及对血浆生长分化因子15(GDF15)水平和血管再通率的影响。方法选择2018年1月-2019年3月北京急救中心收治的心肌梗死患者78例作为研究对象,随机分为对照组(39例)和观察组(39例)。对照组采用阿司匹林治疗,观察组在对照组基础上联合替格瑞洛治疗,治疗后4周对患者疗效进行评估并完成6个月随访,比较两组血清炎症因子水平、血浆GDF15水平、血管再通率、安全性及不良事件发生率。结果观察组治疗后4周白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)及GDF15水平均低于对照组,差异有统计学意义(t=6.302、7.416、8.436、7.437,P<0.05)。观察组治疗后1、3个月血管再通率高于对照组,差异有统计学意义(χ2=5.209、7.612,P<0.05)。两组治疗过程中恶心呕吐、头痛嗜睡及肝肾异常发生率差异无统计学意义(P>0.05);观察组治疗后心源性死亡、心肌梗死、脑出血发生率低于对照组,差异有统计学意义(χ2=5.341、6.123、5.092,P<0.05)。结论阿司匹林联合替格瑞洛用于心肌梗死患者中能降低炎症因子及血浆GDF15水平,提高血管再通率,降低不良事件发生率,安全性较高,值得推广应用。Objective To investigate the clinical effect of aspirin combined with ticagrelor in patients with myocardial infarction and its effect on plasma growth differentiation factor 15(GDF15) level and vascular recanalization rate.Methods 78 patients with myocardial infarction in Beijing Emergency Medical Center from January 2018 to March 2019 were selected as subjects and randomly divided into a control group(39 cases) and an observation group(39 cases).The control group was treated with aspirin.The observation group was combined with ticagrelor on the basis of the control group.The effectiveness of the treatment was evaluated 4 weeks after the treatment and the 6-month follow-up was completed.The levels of serum inflammatory factors,plasma GDF15 and blood vessels recanalization rate,safety and incidence of adverse events were compared between the two groups.Results The levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP) and GDF15 in the observation group were lower than those in the control group 4 weeks after treatment(t=6.302,7.416,8.436,7.437,P<0.05).The vascular recanalization rate in the observation group was higher than that in the control group 1 and 3 months after treatment(χ~2=5.209,7.612,P<0.05).The incidence of nausea and vomiting,headache,drowsiness and liver and kidney abnormalities were not statistically significant in the two groups during treatment(P>0.05).The incidence of cardiogenic death,myocardial infarction and cerebral hemorrhage in the observation group was lower than that in the control group(χ~2=5.341,6.123,5.092,P<0.05).Conclusion Aspirin combined with ticagrelor could reduce the levels of inflammatory factors and plasma GDF15 in patients with myocardial infarction,increase the rate of vascular recanalization,reduce the incidence of adverse events,and had high safety.

关 键 词：阿司匹林 替格瑞洛 心肌梗死 血浆生长分化因子15 

分 类 号：R543[医药卫生—心血管疾病]