替格瑞洛联合阿司匹林对老年急性ST段抬高型心肌梗死伴糖尿病患者血清视黄醇结合蛋白4、 高敏C反应蛋白水平及预后的影响  

Effects of ticagreloRcombined with aspirin on serum retinol-binding protein 4 and high-sensitivity C-reactive protein levels and prognosis in elderly patients with acute ST-segment elevation myocardial infarction and diabetes mellitus

作　　者：岑开源 宋仁义 蒋英全 杜莹 李晶[3] 于海波[4] 覃远文 CEN Kai-yuan;SONG Ren-yi;JIANG Ying-quan;DU Ying;LI Jing;YU Hai-bo;QIN Yuan-wen(Department of CardiovasculaRMedicine,the Guidong People′s Hospital of Guangxi Zhuang Autonomous Region,Wuzhou 543000,China;Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100000,China;School of Basic Medicine,Jiamusi University,Jiamusi 154000,China;Department of CardiovasculaRMedicine,the First Affiliated Hospital of Jiamusi University,Jiamusi 154000,China)

机构地区：[1]广西壮族自治区桂东人民医院心血管内科,梧州市543000 [2]中国医学科学院北京协和医学院,北京市100000 [3]佳木斯大学基础医学院,黑龙江省佳木斯市154000 [4]佳木斯大学附属第一医院心血管内科,黑龙江省佳木斯市154000

出　　处：《广西医学》2021年第9期1065-1068,1077,共5页Guangxi Medical Journal

基　　金：黑龙江省卫生计生委科研课题(2014-241)。

摘　　要：目的探讨替格瑞洛联合阿司匹林对老年急性ST段抬高型心肌梗死(ASTEMI)伴糖尿病患者血清高敏C反应蛋白(hs-CRP)、视黄醇结合蛋白4(RBP4)水平及预后的影响。方法将286例ASTEMI伴糖尿病患者随机分为对照组和观察组,各143例。对照组给予氯吡格雷联合阿司匹林肠溶片治疗,观察组给予替格瑞洛联合阿司匹林肠溶片治疗。所有患者均行经皮冠状动脉介入术治疗。比较术前和术后第3天、第7天、第14天两组患者RBP4和hs-CRP水平的变化,观察两组治疗30 d后的临床主要不良心血管事件(MACE)及不良出血事件。结果在术后第3天、第7天、第14天,观察组的RBP4水平低于对照组,在术后第7天、第14天,观察组的hs-CRP水平低于对照组(均P<0.05)。观察组患者的MACE总发生率低于对照组(P<0.05),但两组患者的不良出血事件发生率比较,差异无统计学意义(P>0.05)。结论与氯吡格雷联合阿司匹林相比,对于老年ASTEMI伴糖尿病患者,替格瑞洛联合阿司匹林可更有效地降低hs-CRP和RBP4水平,抑制血栓和抗炎效应更优,MACE更少,且不增加出血风险,安全性较高。Objective To investigate the effects of ticagreloRcombined with aspirin on serum high-sensitivity C-reactive protein(hs-CRP)and retinol-binding protein 4(RBP4)levels and prognosis in elderly patients with acute ST-segment elevation myocardial infarction(ASTEMI)and diabetes mellitus.Methods Two hundred and eighty-six patients with ASTEMI and diabetes mellitus were randomly divided into control group(n=143)and observation group(n=143).The control group was treated with clopidogrel combined with Aspirin Enteric-Coated Tablets,while the observation group received the therapy of ticagreloRand Aspirin Enteric-Coated Tablets.All patients underwent percutaneous coronary intervention.Changes in the levels of RBP4 and hs-CRP before operation and on the 3rd,7th and 14th day afteRoperation were compared between the two groups,clinical majoRadverse cardiovasculaRevents(MACE)and adverse bleeding events 30 days afteRtreatment were observed in both groups.Results On the 3rd,7th and 14th day afteRoperation,the observation group reported a loweRRBP4 level than the control group,on the 7th and 14th day afteRoperation,the observation group exhibited a loweRhs-CRP level than the control group(all P<0.05).The total incidence rate of MACE in the observation group was loweRthan that in the control group(P<0.05),however,no statistically significant difference was found in incidence rate of adverse bleeding events between the two groups(P>0.05).Conclusion FoRelderly patients with ASTEMI and diabetes mellitus,ticagreloRcombined with aspirin can reduce the levels of RBP4 and hs-CRP more effectively,exerts superioRefficacy against thromboembolism and inflammation oveRclopidogrel combined with aspirin,has feweRMACE and does not increase the risk of bleeding,achieving higheRsafety.

关 键 词：急性ST段抬高型心肌梗死 糖尿病 替格瑞洛 视黄醇结合蛋白4 高敏C反应蛋白 老年人 

分 类 号：R542.22[医药卫生—心血管疾病]