目的 比較替格瑞洛和西洛他唑治療冠心病合并糖尿病PCI術(shù)后血栓形成的臨床療效。方法 選取2014年1月-2016年1月在滄縣醫(yī)院接受PCI手術(shù)治療的冠心病合并糖尿病患者88例，隨機分為對照組（44例）和治療組（44例）。對照組患者口服西洛他唑片，100 mg/次，2次/d；治療組口服替格瑞洛片，第1天180 mg/次，1次/d，以后90 mg/次，2次/d。兩組患者均治療30 d。比較兩組治療前后血小板抑制率、血清細胞因子水平和心血管不良事件發(fā)生率。結(jié)果 治療后，兩組患者血小板抑制率均明顯升高（P<0.05），且與對照組相比，治療組患者升高更顯著，兩組比較差異有統(tǒng)計學意義（P<0.05）。治療后，兩組血清超敏反應(yīng)C蛋白（hs-CRP）、IL-6、CD40L、脂蛋白磷脂酶A2（Lp-PLA2）水平均明顯低于同組治療前，同組比較差異具有統(tǒng)計學意義（P<0.05），且治療后治療組比對照組降低更明顯，兩組比較差異具有統(tǒng)計學意義（P<0.05）。治療過程中，治療組心血管不良事件發(fā)生率為11.36%，顯著低于對照組的29.55%，兩組比較差異有統(tǒng)計學意義（P<0.05）。結(jié)論 替格瑞洛可更好的拮抗冠心病合并糖尿病PCI術(shù)后血小板聚集，并可有效降低機體炎癥因子水平，具有一定的臨床推廣應(yīng)用價值。

Objective To compare clinical curative effect of ticagrelor and cilostazol in treatment of thrombosis of coronary heart disease with diabetes after PCI. Methods Patients (88 cases) with coronary heart disease with diabetes treated with PCI in Cangxian Hospital from January 2014 to January 2016 were randomly divided into control (44 cases) and treatment (44 cases) groups. Patients in the control group were po administered with Cilostazol Tablets, 100 mg/time, twice daily. Patients in the treatment group were po administered with Ticagrelor Tablets, 180 mg/time for first day, then 90 mg/time, twice daily. Patients in two groups were treated for 30 d. After treatment, the platelet inhibitory rate, serum cytokines level, and adverse cardiovascular events in two groups before and after treatment were compared. Results After treatment, the platelet inhibitory rate in two groups was significantly increased (P < 0.05), and compared with the control group, platelet inhibitory rate in the treatment group was significantly increased, with significant difference between two groups (P < 0.05). After treatment, the hs-CRP, IL-6, CD40L, and Lp-PLA2 levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the serum cytokines levels in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). In the course of treatment, the adverse cardiovascular event rate in the treatment group was 11.36%, which were significantly lower than 29.55% in the control group, and there were differences between two groups (P < 0.05). Conclusion Ticagrelor can effectively antagonize the platelet aggregation after PCI of coronary heart disease with diabetes, and reduce the inflammatory factor, which has a certain clinical application value.

滄州市科技課題（162302171）