Résumé
Objective : To explore therapeutic effect of ticagrelor combined low molecular weight heparin (LMWH ) on acute coronary syndrome (ACS) and its influence on serum levels of IL-17 ,MMP-9 ,soluble intercellular adhesion molecule (sICAM)-1 and major adverse cardiovascular events(MACE).Methods :A total of 102 ACS patients hospitalized in our hospital from Feb 2016 to Oct 2017 were selected ,randomly and equally divided into atorvastatin group and ticagrelor group ,both groups received corresponding treatment based on routine treatment and LMWH for two weeks .Therapeutic effect ,serum levels of hsCRP ,IL-17 ,MMP-9 ,sICAM-1 ,LVEF ,LVEDd ,LVESd ,peak early diastolic transmitral flow velocity/peak late diastolic transmitral flow velocity (E/A) changes and incidence rate of MACE were compared between two groups.Results :Total effective rate of ticagrelor group was significantly higher than that of atorvastatin group (94.12% vs.80.39%,P＝0.038).Compared with before treatment ,there were significant reductions in serum levels of hsCRP ,IL-17 ,MMP-9 and sICAM-1 ,LVEDd ,LVESd ,and significant rise in LVEF and E/A in two groups after treat-ment , P＜0.01 all.Compared with atorvastatin group ,there were significant reductions in serum levels of hsCRP [(2.96 ± 0.72)mmol/L vs.(1.46 ± 0.41)mmol/L] ,IL-17 [(25.36 ± 4.27)ng/L vs.(19.58 ± 4.46) ng/L] ,MMP-9 [(58.75 ± 10.75)g/L vs.(35.16 ± 9.63)g/L] ,sICAM-1 [(174.53 ± 28.36)ng/ml vs.(124.38 ± 27.34)ng/ml] ,LVESd[(48.01 ± 4.31)mm vs.(39.72 ± 4.16)mm] ,LVEDd[(57.37 ± 5.98)mm vs.(46.51 ± 5.36)mm] and significant rise in LVEF [(45.42 ± 5.68)% vs.(54.33 ± 6.39)%] and E/A[(1.38 ± 0.29) vs.(1.53 ± 0.31)] in ticagrelor group after treatment , P＜0.05 or ＜0.01. Incidence rate of MACE in ticagrelor group was significantly lower than that in atorvastatin group (7.84% vs.23.53%, P＝0.029).Conclusion :Ticagrelor combined LMWH can significantly improve therapeutic effect , lower serum levels of inflammatory factors ,improve cardiac function and reduce incidence rate of MACE in ACS patients .