高负荷剂量氯吡格雷对急性冠脉综合征患者介入治疗后血清sCD40L和hs-CRP浓度的影响

被引：7

作者：

陈志华 ^{[1
,2
]}

邢波 ^{[1
,2
]}

孙定军 ^{[1
,2
]}

林德洪 ^{[1
,2
]}

杜子军 ^{[1
,2
]}

吴淼 ^{[1
,2
]}

机构：

[1] 中南大学湘雅医学院附属海口医院

[2] 海口市人民医院心血管内科

来源：

岭南心血管病杂志 | 2013年 / 19卷 / 02期

关键词：

冠状动脉疾病; 氯吡格雷; 可溶性CD40配体; 高敏C反应蛋白;

D O I：

暂无

中图分类号：

R541.4 [冠状动脉（粥样）硬化性心脏病（冠心病）];

学科分类号：

1002 ; 100201 ;

摘要：

目的探讨高负荷剂量氯吡格雷对急性冠脉综合征(acute coronary syndrome,ACS)患者介入治疗后血清sCD40L和高敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)水平的影响。方法选择ACS患者190例分为高负荷剂量组94例(首剂负荷剂量600 mg,以后每天氯吡格雷150 mg,共用7 d,而后以每天氯吡格雷75 mg维持治疗)和标准剂量组96例(首剂负荷剂量300 mg,以后每天氯吡格雷75 mg维持治疗)。于服氯吡格雷前,经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗前,术后第1天,术后第7天,术后第30天血清sCD40L和hs-CRP的浓度,并记录患者术后1、3、6个月发生主要心血管事件、出血事件的情况。结果高负荷剂量组PCI治疗后不同时间点血清可溶性CD40配体(sCD40L)、hs-CRP浓度均低于标准剂量组,差异有统计学意义(P<0.05)。sCD40L与hs-CRP的变化趋势的相关性检验结果显示两者呈正相关(皮尔森相关系数r=0.128,P<0.001)。结论高剂量氯吡格雷比标准剂量氯吡格雷对sCD40L、hs-CRP的抑制作用更强;当氯吡格雷抑制炎症反应产物hs-CRP产生的同时也会抑制炎症产物sCD40L的产生。

引用

页码：160 / 163+188 +188

页数：5

共 18 条

[1]

Impact of clopidogrel loading dose on clinical outcome in patients undergoing percutaneous coronary intervention:a systematic review and meta-analysis. Siller-Matula JM,Huber K,Christ G,et al. Heart . 2011

[2]

The levels of circulating markers of atherosclerosis and inflammation in subjects with different degrees of body mass index:Soluble CD40 ligand and high-sensitivity C reactive protein. GULDIKEN S,DEMIR M,ARIKAN E,et al. Thrombosis Research . 2007

[3]

Double-dose versus standard-dose clopidogrel and high-dose verus low-dose aspirin in individuals undergoing percutaneous coronary intervention for acute coronary syndromes (CURRENTOASIS 7):a randomized factorial trial. MEHTA S R,TANGUAY J F,EIKELBOOM J W,et al. The Lancet . 2010

[4]

A randomized comparsion of high clopidogrel loading doses in patients with non-ST-segment elevation acute coronary syndromes:the ALBION (Assenssment of the Best Loading Dose of clopidogrel to Blunt Platelet Activation inflammation and ongoing Necrosis)tri. MONTALESCOT G,SIDERIS G,MWULEMAN C,et al. Journal of the American College of Cardiology . 2006

[5]

Platelet CD40 ligand (CD40L) ? subcellular localization, regulation of expression, and inhibition by clopidogrel[J] . &nbspPlatelets . 2001 (2)

[6]

Effect of clopidogrel pretreatment on inflammatory marker expression in patients undergoing pereutaneous coronary intervention. Quinn MJ,Bhatt DL,Zidar F,et al. The American Journal of Cardiology . 2004

[7]

Platelet CD40 ligand (CD40L)-subcellular localization, regulation of expression, and inhibition by clopidogrel. Hermann A,Rauch BH,Braun M,et al. Platelets . 2001

[8]

Platelet CD40 ligand (CD40L)-subcellular localization, regulation of expression, and inhibition by clopidogrel. Hermann A,Rauch BH,Braun M,et al. Platelets . 2001

[9]

C-reactive protein frequently colocalizes with the terminal complement complex in the intima of early atheroclerotic leisions of human coronary rateries. Torzewski J,Torzewski M,Bowyer DE,et al. Arteriosclerosis . 1998

[10]

Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. Mehta SR,Yusuf S,Peters RJ,et al. Lancet,The . 2001

← 1 2 →