目的探讨替格瑞洛与氯吡格雷治疗冠心病心脏介入术后对冠状动脉内皮功能的作用及影响因素。方法选择2006年-2012年某医院心脏介入术后患者120例,随机分为替格瑞洛组(n=60,实验组)和氯吡格雷组(n=60,对照组),在常规口服阿司匹林抗血小板治疗基础上分别加用替格瑞洛或氯吡格雷。应用双抗体夹心法检测两组患者在PCI后1个月、3个月、6个月的同一时间节点的内皮素-1和诱导性一氧化氮合成酶含量;应用血管内超声技术评估两组患者药物治疗后1个月、3个月、6个月冠状动脉非依赖性血管内皮舒张功能、血管内皮依赖性舒张功能、峰值血流变化率、静息状态血流量和静息状态内径;并记录用药期间主要心血管不良事件及血栓或出血等相关并发症。结果心脏介入术后服药1个月、3个月、6个月双抗体夹心法血清内皮素-1测定结果实验组均显著低于对照组;血清诱导性一氧化氮合成酶含量测定结果则显著高于对照组患者;血管内超声技术检测结果显示两组患者在治疗终点峰值血流变化率和非依赖性血管内皮舒张功能百分比显著提高;而血管内皮依赖性舒张功能百分比、静息状态血流量、冠状动脉静息状态内径的改善效果、主要心血管不良事件及血栓或出血等相关并发症差异均无统计学意义。结论替格瑞洛较氯吡格雷能显著改善心脏介入术后患者的非依赖性血管内皮舒张功能,而对血管内皮依赖性舒张功能改善作用有限。说明替格瑞洛在心脏介入术后具有一定的抗炎及改善内皮功能,并且在安全性上不亚于氯吡格雷。 Objective To investigate the effects of ticagrelor and clopidogrel on coronary endothelial function after coronary intervention in patients with coronary heart disease and its influencing factors. Methods A total of 120 patients after cardiac intervention in a hospital from 2006 to 2012 were randomly divided into ticagrelor group (n = 60, experimental group) and clopidogrel group (n = 60, control group) Aspirin antiplatelet therapy based on the addition of ticagrelor or clopidogrel. The levels of endothelin-1 and inducible nitric oxide synthase were detected at the same time points of 1 month, 3 months and 6 months after PCI in both groups by double antibody sandwich method. The intravascular ultrasound Patients at 1 month, 3 months and 6 months after treatment with coronary artery-independent vascular endothelial dilation function, endothelium-dependent vasodilation, peak blood flow rate, resting blood flow and resting state diameter; and Major adverse cardiovascular events and related complications such as thrombosis or bleeding during the course of medication were recorded. Results The serum levels of endothelin-1 in the two groups were significantly lower than those in the control group at 1 month, 3 months and 6 months after cardiac intervention. The results of serum-inducible nitric oxide synthase Higher than the control group. The results of intravascular ultrasound showed that the peak blood flow rate and the percentage of independent endothelium-dependent vasodilation were significantly increased at the end of treatment in both groups. However, the percentage of endothelium-dependent vasodilatation, resting blood flow , The effect of improving the diameter of the coronary artery resting state, the main cardiovascular adverse events and thrombosis or bleeding-related complications were not statistically significant. Conclusion Ticagrelor compared with clopidogrel can significantly improve the non-dependent vasodilatation in patients after cardiac intervention, and it has a limited effect on the improvement of endothelium-dependent vasodilatation. Indicating that ticagrelor has some anti-inflammatory and endothelial function after cardiac intervention and is as safe as clopidogrel.