氯吡格雷强化治疗对老年急性心肌梗死患者炎性反应及氧化-抗氧化水平影响

目的:探讨氯吡格雷强化治疗对老年急性心肌梗死患者炎性反应及氧化-抗氧化水平的影响。方法:选择我院2012年1月至2016年12月收治的400例老年急性心肌梗死患者,根据随机数字表法分为观察组及对照组。对照组给予常规治疗,观察组给予氯吡格雷强化治疗,对比两组患者的疗效,治疗期间的不良心血管事件及不良反应的发生情况,治疗前后的血清白介素1 (interleukin-1,IL-1)、白介素2 (interleukin-2,IL-2)、白介素6 (interleukin-6,IL-6)、白介素10 (interleukin-10,IL-10)水平及超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(malondialdehyde,MDA)、过氧化酶(catalase,CAT)及谷胱甘肽氧化物酶(glutathione peroxidase,GSHPX protein)水平。结果:治疗后,观察组的总有效率为92.50%,明显高于对照组(72%,P0.05);观察组的心血管不良事件发生率明显低于对照组(P0.05);两组的不良反应发生率对比差异无统计学意义(P0.05)。两组治疗后的血清IL-1、IL-2、IL-6、IL-10、MDA水平均较治疗前明显下降,且观察组以上指标水平均明显低于对照组(P0.05),而两组治疗后的血清SOD、CAT、GSHPX水平均较治疗前明显上升,且观察组以上指标水平均明显高于对照组(P0.05)。结论:与常规治疗相比,氯吡格雷强化治疗可显著提高老年急性心肌梗死患者的临床疗效,这可能与有效减轻患者的炎症反应,增强抗氧化作用有关。

Effect of Intensive Treatment combined with Clopidogrel on the Inflammatory Response and Oxidation-antioxidant Levels in Elderly Patients with Acute Myocardial Infarction

ABSTRACT Objective: To investigate the effect of clopidogrel intensive therapy on the inflammatory reaction and oxidation-antiox- idant level in elderly patients with acute myocardial infarction. Methods: 400 cases of elderly patients with acute myocardial infarction from Jan. 2012 to Dec. 2016 in our hospital were selected and divided into the observation group and the control group according to ran- dom number table method, the control group was given conventional treatment, the observation group was given intensive treatment with clopidogrel, the therapeutic effects, incidence of adverse cardiovascular events and adverse reactions, serum levels of interleukin-1 (IL-1), interleukin-2 (IL-2), interleukin-6 (IL-6), interleukin-10 (IL-10) and superoxide dismutase (SOD) malondialdehyde (MDA), catalase (CAT) and glutathione peroxidase (GSHPX protein) levels before and after treatment were compared between the two groups. Results: After treatment, the total effective rate of observation group was 92.50%, which was significantly higher than that of the control group (72%, P<0.05); the incidence of adverse cardiovascular events in the observation group was significantly lower than that of the control group (P<0.05); there was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). After treat- ment, the levels of serum IL-1, IL-2, IL-6, IL-10 and MDA in both groups were significantly lower than those before treatment, and the above indexes in the observation group were significantly lower than those of the control group (P<0.05). the levels of serum SOD, CAT and GSHPX in observation group were significantly lower than those in control group (P<0.05). However, the levels of SOD, CAT and GSHPX in the two groups after treatment were significantly higher than those before treatment, and the above indexes in the observation group were significantly higher than those in the control group (P<0.05). Conclusion: Compared with conventional therapy, clopidogrel intensive therapy can significantly improve the clinical efficacy of elderly patients with acute myocardial infarction, which may be related to the effective reduction of inflammatory reaction and enhancement of antioxidation.