目的 探討口服替格瑞洛治療不穩(wěn)定型心絞痛（UA）合并糖尿病老年患者的治療效果及對患者血清炎癥因子水平的影響。方法 選取2015年3月-2017年9月在安國市醫(yī)院就診的UA合并2型糖尿病老年患者100例，隨機(jī)分為觀察組（n=50）和對照組（n=50）。對照組在常規(guī)基礎(chǔ)給予患者口服氯吡格雷片，觀察組在常規(guī)基礎(chǔ)給予患者口服替格瑞洛片，均治療6個月。對比兩組心絞痛發(fā)作情況、血清高敏C反應(yīng)蛋白（hs-CRP）、白細(xì)胞介素-6（IL-6）、CD40配體（CD 40L）水平及循環(huán)血內(nèi)皮細(xì)胞（CEC）。結(jié)果 觀察組總有效率86.00%，顯著高于對照組的總有效率60.00%，差異有統(tǒng)計學(xué)意義（P<0.05）。治療后兩組發(fā)作頻率、發(fā)作間隔和發(fā)作持續(xù)時間與治療前比較差異均顯著（P<0.05）；且觀察組發(fā)作頻率和發(fā)作持續(xù)時間均顯著少于對照組（P<0.05），發(fā)作間隔顯著長于對照組（P<0.05）。治療后，兩組血清hs-CRP、IL-6和外周血CEC均較治療前顯著降低，CD40L水平顯著升高（P<0.05）；且觀察組血清hs-CRP、IL-6水平和外周血CEC較對照組顯著降低（P<0.05）；兩組CD40L水平比較，差異無統(tǒng)計學(xué)意義。結(jié)論 口服替格瑞洛治療UA合并糖尿病老年患者效果顯著，且能降低血清炎癥因子水平，值得臨床推廣。

Objective To investigate the effect of oral administration ticagrelor in treating unstable angina (UA) with diabetes mellitus elderly patients and the level of serum inflammatory factors.Methods 100 elderly patients with UA and 2 diabetes in our hospital from March 2015 to September 2017 and were randomly divided into the observation group (ticagrelor,n=50) and the control group (clopidogrel,n=50).The incidence of angina pectoris,serum hs-CRP,IL-6,CD40L levels and peripheral blood CEC were compared between the two groups.Results The total effective rate of the observation group was 86.00%(43/50),which was significantly higher than that of the control group 60.00%(30/50)(P< 0.05).The frequency,interval and duration of attack in the two groups were significantly different from those before treatment (P< 0.05),and the seizure frequency and duration of seizures in the observation group were significantly less than those in the control group (P< 0.05),and the interval between the seizures was significantly longer than that of the control group (P< 0.05).The levels of serum hs-CRP,IL-6 and CEC in peripheral blood of the observation group were significantly lower than those of the control group (P< 0.05).There was no significant difference in the level of CD40L between the two groups.Conclusion Oral administration ticagrelor in treating UA with diabetes mellitus elderly patients is effective and can reduce the level of serum inflammatory factors.It is worthy of clinical promotion.

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