不同剂量阿司匹林干预对非ST 段抬高性急性冠脉综合征患者机体炎症水平及血管内皮功能的影响

目的:探讨不同剂量阿司匹林对接受保守治疗的非ST段抬高性ACS患者机体炎症水平及血管内皮功能的影响,为ACS患者阿司匹林的应用提供更充分的临床依据。方法:200例患者以不稳定型心绞痛和非ST段抬高性心肌梗死分层后随机分2组,阿司匹林高剂量治疗组,阿司匹林低剂量治疗组。阿司匹林高剂量组患者在入院给予300mg阿司匹林负荷后继以150mg/d治疗。阿司匹林低剂量组患者入院给予150mg负荷后继以75mg/d维持,两组患者其余基础的治疗一致。患者在入院时及干预1周后,抽取静脉血检测患者血炎症因子hs-CRP、IL-6、TNF-α及反应血管内皮功能的NO、ET-1的变化。结果:①经治疗后,2组患者的炎症因子水平均显著下降,P<0.05或P<0.01;同时发现高剂量阿司匹林具有更显著的抗炎及改善血管内皮功能的作用,两组间指标比较,差异显著,P<0.05。②在因出现不良反应而终止试验的人数方面,两组间无显著性差异,P>0.05。结论:高剂量阿司匹林具有更显著拮抗机体炎症及改善血管内皮功能的作用,值得在ACS患者的治疗中进行推广应用。

Curative Effect Observation of Inflammation Level and Endothelial Functionon the Non-ST-Segment Elevation in Acute Coronary Syndrome withDifferent Doses of Aspirin

Objective: In order to provide more clinical information to the application of aspirin in patients with ACS,we explore the effects of different doses of aspirin on non-ST segment elevation ACS patients’ inflammatory levels and vascular endothelial function.Methods: 200 cases of ACS were divided into two levels,the unstable angina and non-ST segment elevation myocardial infarction,then divided into two groups,the aspirin high dose group,the aspirin low dose group.For aspirin high dose group,patients were given 300mg aspirin first,and then 150mg aspirin each day.For aspirin low dose group,patients were given 150mg aspirin first,and then 75mg aspirin each day,all the other base therapy on the same.The observation time is 7 days.All the patients took blood from the vein to detect the in-flammatory factor the hs-CRP,IL-6,TNF-α,and the NO,ET-1.Results: After 7 days treatment,inflammatory cytokines were significantly decreased in patients of the two groups,P <0.05 or P <0.01;high-dose aspirin treatment has more pronounced anti-inflammatory and im-proved endothelial function,P <0.05.As for the patients number terminated due to the adverse reactions in trials,the two groups showed no significant difference,P> 0.05.Conclusion: High-dose aspirin has more pronounced antagonistic inflammatory and improve the role of vascular endothelial function,it is worth to promote the application in the treatment of patients with ACS.