氯吡格雷对非ST段抬高型急性冠脉综合征患者血清sCD40L水平的影响.pdf

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1、680·医学杂志2014年8月第36卷第8期NingxiaMedJ，Aug．2014，．患者血清sCD40L水平的影响马萍，马巧红，徐清斌[摘要]目的探讨非sT段抬高型急性冠脉综合征患者服用不同剂量氯吡格雷早期对血清sCD40L水平变化的影响。方法选取非sT段抬高型急性冠脉综合征患者67例，均给予300mg负荷量氯吡格雷后分为2组，分别序贯给予维持剂量氯吡格雷75mg·d(33例)、150mg·d(34例)，分别于服用氯吡格雷前、服用负荷剂量氯吡格雷24h、服用氯吡格雷第5天取患者肘静脉血，用Elisa法测定血清sCD40L浓度。选取正常对照组28例，不予药物干预。结果正常对照组血清

2、sCD40L水平明显低于非sT段抬高型急性冠脉综合征患者血清sCD40L水平(P<0．05)。非sT段抬高型急性冠脉综合征患者服药前血清sCD40L浓度高于服用负荷量氯吡格雷24h后血清sCD40L浓度，同时高于序贯常规剂量氯吡格雷第5天血清sCD40L浓度(P<0．05)；序贯75mg·d与序贯150mg·d第5天对sCD40L的浓度影响差异无统计学意义(P>0．05)。结论非sT段抬高型急性冠脉综合征患者血清sCD40L高于非冠心病人群，氯吡格雷可显著降低非sT段抬高型急性冠脉综合征患者血清sCD40L水平。[关键词]非sT段抬高型急性冠脉综合征；不同剂量，氯吡格雷；可溶性CD4

3、0配体[中图分类号]t／541[文献标识码]AEfectsofdiferentdosesofclopidogrelonserumsCD40LlevelinNST—ACSpatientsMAP凡g‘，MAQiaohong，XUQingbin．1．DepartmentofCardiology，GeneralHospitalofNingxiaMedicalUniversity，Yinchuan750004，China；2．NingxiaMedicalUniversity，Yinchuan750004，ChinaCorrespondingauthor：XUQingbin，Email：XH—q

4、b@163．con[Abstract]ObjectiveToinvestigatethechangesofSenlmsCD40LlevelinNST—ACSpatientsafteradministrationofdifferentdosesofclopidogre1．Methods28caseswithoutadministrationofdrugswasselectedintonormalgroup．67patientswithNST—ACStreatedwith300mgloadingdoseofclopidogrelwererandomlydividedintotwogrou

5、ps，andsequentiallyreceivedmaintenancedoseofclo—pidogrelwith75mg·d(33cases)and150mg·d(34cases)，respectively．SerumconcentrationsofsCD40Lweredetectedbeforetakingclopidogrel，24hoursand5thdaysaftertaking300mgloadingdoseofclopidopre1．SerumconcentrationsofsCD40LweremeasuredbyElisa．ResultsTheserumlevel

6、sofsCIMOLofnormalgroupweresignificantlylowerthanthatinnonSTsegmentelevationacutecor—onarysyndromegroup(P<0．05)．Thebaselineconcentrationwashigherthantaking300mgloadingdoseofelopidogrel24hlaterindNST—ACSpatients，andatthesametime，washigherinsequentialroutinedoseofclopidogrelthefifthdays(P<0．05)．Th

7、erewasnosignificantdifferenceinsequential75mg·d。。andsequential150mg·dthefifthdaysregardingitsimpactonsCD40Lconcentration(P>0．05)．ConclusionThesCD40LofNonSTsegmentelevationacutecoronarysyndromepatientsishigherthanthatinnormalgroup．