氯吡格雷联合低分子肝素对老年心肌梗死患者血清血脂及炎性因子的影响

doi:10.3969/j.issn.1000-8535.2021.02.010

广州医药 ›› 2021, Vol. 52 ›› Issue (2): 46-49.DOI: 10.3969/j.issn.1000-8535.2021.02.010

氯吡格雷联合低分子肝素对老年心肌梗死患者血清血脂及炎性因子的影响

陈希妍, 张建新, 牛丽丹, 孔令宇, 杨飞云, 石金河

新乡医学院第一附属医院急诊科(卫辉 453100)

收稿日期:2020-11-04 出版日期:2021-03-20 发布日期:2021-11-25
通讯作者: 石金河,E-mail:sjh4407901@163.com
基金资助:
国家自然科学青年基金(81600677)

Effects of clopidogrel combined with low molecular weight heparin on serum lipids and inflammatory factors in elderly patients with acute myocardial infarction

CHEN Xiyan, ZHANG Jianxin, Niu Lidan, KONG Lingyu, YANG Feiyun, SHI Jinhe

Department of Emergency, The First Affiliated Hospital of Xinxiang Medical University, Weihui 453100, China

Received:2020-11-04 Online:2021-03-20 Published:2021-11-25

摘要/Abstract

摘要： 目的研究氯吡格雷联合低分子肝素对老年急性心肌梗死(acute myocardial infarction, AMI)患者血清中血脂及炎性因子的影响,为临床AMI的治疗提供参考依据。方法选取新乡医学院第一附属医院于2016年10月—2019年11月期间收治的老年AMI患者112例,按照随机分配的原则分成两组,即对照组和观察组,每组病例各56例,治疗方式为对照组单给予口服氯吡格雷进行治疗,观察组给予口服氯吡格雷与皮下注射低分子肝素联合治疗,比较治疗前后两组患者血清中甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)及低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDH-C),炎性因子的水平变化及心功能的改变情况。结果与治疗前相比较,治疗后对照组和观察组患者血清TG、TC及LDH-C水平均降低,炎性因子TNF-α,IL-1β,CRP,IL-6的水平均降低,患者的左心室后壁厚度、左心室舒张末期内径均有降低,射血分数升高;而与对照组治疗后相比较,治疗后观察组患者血清TG、TC及LDH-C水平进一步降低,炎性因子TNF-α,IL-1β,CRP,IL-6的水平进一步降低,患者的左心室后壁厚度、左心室舒张末期内径均降低,而射血分数升高,差异有统计学意义。结论氯吡格雷联合低分子量肝素可通过降低血清中血脂的水平,抑制AMI过程中的炎症反应,减少炎性因子的释放,提高患者的心功能,改善患者的病情。

关键词: 急性心肌梗死, 氯吡格雷, 低分子肝素, 血脂, 炎性因子

Abstract: Objective To explore the effects of clopidogrel combined with low molecular weight heparin on serum lipids and inflammatory factors in elderly patients with acute myocardial infarction, and provide reference for clinical treatment of AMI. Methods 112 elderly patients with AMI admitted to the First Affiliated Hospital of Xinxiang Medical University from October 2016 to November 2019 were randomly divided into control group and observation group,56 cases in each group.The control group was treated with clopidogrel alone, and the observation group was treated with clopidogrel combined with low molecular weight heparin. The levels of serum TG, TC and LDH-C, inflammatory factors and cardiac function were compared between the two groups before and after treatment. Results Compared with before treatment, the levels of serum TG, TC and LDH-C decreased, and the levels of inflammatory factors TNF-α, IL-1β, CRP and IL-6 decreased in the observation group and the control group after treatment. The left ventricular posterior wall thickness and LVEDD decreased, but LVEF increased in the observation group and control group after treatment. Compared with control group after treatment, the levels of serum TG, TC and LDH-C decreased, and the levels of inflammatory factors TNF-α, IL-1β, CRP and IL-6 decreased, the left ventricular posterior wall thickness and LVEDD decreased, but LVEF increased further in observation group after treatment. Conclusion Clopidogrel combined with low molecular weight heparin may improve the patient's cardiac function, then improve the patient's condition through reducing the level of serum lipids, inhibit the inflammatory reaction in AMI, reduce the release of inflammatory factors.

Key words: Acute myocardial infarction, Clopidogrel, Low molecular weight heparin, Serum lipids, Inflammatory factors

陈希妍, 张建新, 牛丽丹, 孔令宇, 杨飞云, 石金河. 氯吡格雷联合低分子肝素对老年心肌梗死患者血清血脂及炎性因子的影响[J]. 广州医药, 2021, 52(2): 46-49.

CHEN Xiyan, ZHANG Jianxin, Niu Lidan, KONG Lingyu, YANG Feiyun, SHI Jinhe. Effects of clopidogrel combined with low molecular weight heparin on serum lipids and inflammatory factors in elderly patients with acute myocardial infarction[J]. Guangzhou Medical Journal, 2021, 52(2): 46-49.

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氯吡格雷联合低分子肝素对老年心肌梗死患者血清血脂及炎性因子的影响

Effects of clopidogrel combined with low molecular weight heparin on serum lipids and inflammatory factors in elderly patients with acute myocardial infarction

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