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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。
Objective: To investigate the effects of different doses of aspirin on inflammation and vascular endothelial function in non-ST-segment elevation ACS patients undergoing conservative treatment and to provide a more adequate clinical evidence for the application of aspirin in patients with ACS. Methods: 200 patients were divided into unstable angina pectoris and non-ST-segment myocardial infarction. The patients were randomly divided into two groups: high-dose aspirin group and low-dose aspirin group. Patients in the aspirin high-dose group were given 300 mg of aspirin loading on admission followed by 150 mg / d. Patients in the aspirin low-dose group were given a 150 mg load followed by 75 mg / d, and the rest of the two groups were treated consistently. At admission and one week after the intervention, blood samples were collected to detect the change of blood inflammatory factors hs-CRP, IL-6, TNF-α and NO, ET-1 in vascular endothelial function. Results: ①After treatment, the levels of inflammatory cytokines decreased significantly in both groups (P <0.05 or P <0.01). At the same time, high-dose aspirin was found to have more significant anti-inflammatory and vascular endothelial function effects. , Significant difference, P <0.05. ② There was no significant difference between the two groups in terms of the number of people who terminated the trial due to adverse reactions (P> 0.05). Conclusion: High-dose aspirin has a more significant effect on antagonizing inflammation and improving endothelial function, which is worthy of promotion and application in the treatment of ACS.