| Background: Acute myocardial infarction(AMI)has a high mortality rate and is a serious disease that threatens human life and health.Current studies have confirmed that its occurrence is caused by a synergistic effect of inflammation and dysfunction of vascular endothelial cells.Due to the inseparable relationship between platelet activation,thrombosis and inflammatory development,antiplatelet drugs can also have anti-inflammatory effects.Whether domestic or foreign in vitro experiments conducted in recent years,or clinical trials in vivo,antiplatelet drugs(ASP,P2Y12 antiplatelet drugs: ticagrelor and clopidogrel)have been confirmed to have direct or indirect resistance.Inflammation.IL-17 a is highly expressed in a variety of cardiovascular diseases and participates in the process of chronic inflammatory reactions.It plays a positive role in stabilizing the body's internal environment and regulating immune function.Numerous studies have found that there is an important link between IL-17 and the pathogenesis of ACS,which can induce and accelerate the rupture of AS plaques.Objective: Try to explore whether the two P2Y12 antiplatelet drugs have significant differences in the improvement of inflammation after PCI in patients with ST-elevation myocardial infarction,and infer which type of P2Y12 antiplatelet drugs can control the serum inflammatory markers in patients with acute myocardial infarction.Significant.Methods: For patients with acute ST-segment elevation myocardial infarction(STEMI),preoperative administration was grouped and clopidogrel(control)group was given clopidogrel sulphate before PCI(Sanofi San Diego,Minsheng Pharmaceutical Co.,Ltd.,Hangzhou,China).Company,Zhunzi H20056410)The loading dose of 600 mg,postoperative maintenance dose of 75 mg/day,oral administration for 12 months.The ticagrelor(experimental)group was given ticagrelor(Belinda,Sweden AstraZeneca AB,Zhuyaozi J20130020)with a loading dose of 180 mg prior to PCI and a maintenance dose of 90 mg 1/12 h after oral administration.12 months;After giving a dose of ticagrelor and clopidogrel to the patient,an emergency coronary intervention was performed.After the operation,the blood vessels were opened and residual stenosis was less than 10%.Myocardial infarction infusion test(thrombolytic in myocardial infarction,TIMI)blood flow grade 3,no acute stent thrombosis.The levels of IL-17 a,a marker of inflammation,were measured by ELISA at baseline,24 hours after surgery,7 days after surgery,and 4 weeks after surgery.The trend of the concentration of sexual indicators.Results: In this study,a total of 123 subjects that met the inclusion criteria after randomization were included.Among them,65 were in the clopidogrel group and 58 were in the ticagrelor group.After chi-square test or independent sample t test,between the two groups in: age,gender composition,BMI(kg/m2),admission body temperature(armpit)°C,heart rate(time/min),respiratory(time/min),systolic blood pressure(mmHg),diastolic blood pressure(mmHg),history of hypertension,hypercholesterolemia,history of diabetes,whether INS treatment,cancer,smoking history and no significant differences in all aspects;After independent sample t-test,the blood coagulation parameters of the subjects were given P2Y12 drug treatment,there was no significant difference(P> 0.05)at baseline,24 hours after surgery,1 week after surgery,and 4 weeks after operation.There was no significant difference in blood lipid parameters(triglycerides,total cholesterol,low-density lipoprotein,high-density lipoprotein)between the postoperative 24 hours,postoperative 1 week,and postoperative 4 weeks(P>0.05)..Subjects routine blood parameters: hemoglobin concentration(Hb),white blood cell count(WBC),red blood cell count(RBC),neutrophil count(NEUTP),lymphocyte count(LYM),monocyte count(MON),Eosinophilic ratio(EOP)and basal ratio(BASOP)were not significantly different at baseline,24 hours after surgery,1 week after surgery,and 4 weeks after operation(P>0.05).Subjects' blood glucose,creatinine and creatine kinase were not significantly different at 24 hours postoperatively,1 week postoperatively,and 4 weeks postoperatively(P>0.05).The two groups of subjects at each time point in the comparison of the two drugs of inflammation indicators,IL-17 a factor levels in patients after 24 hours,1 week after surgery did not show significant differences(P> 0.05).After 4 weeks of treatment,there was a significant difference in IL-17 a levels between the two groups(P < 0.03).For IL-17 a,ticagrelor decreased inflammatory factors more than clopidogrel at 4 weeks postoperatively compared with baseline levels,with P<0.05 as the test level.The difference was statistically significant.Conclusion: This study found that in patients receiving acute ST-segment elevation interventional therapy,after receiving ticagrelor and clopidogrel loading doses and regular treatment,for IL-17 a,only at 4 weeks after surgery and baseline levels In the comparison,ticagrelor caused a greater decrease in inflammatory factors than clopidogrel,with P<0.05 as the test level.The difference was statistically significant.Therefore,we can conclude that ticagrelor has stronger inflammatory inhibition than clopidogrel.It is suggested that the ticagrelor treatment group may be effective in the prevention of arrhythmia and ventricular remodeling after myocardial infarction,and provides new ideas for prevention and treatment.However,a large amount of research is still needed to support this finding. |
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