替格瑞洛对急性冠脉综合征经皮冠状动脉介入治疗围手术期C反应蛋白和心功能的影响
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摘要
探讨替格瑞洛对急性冠脉综合征(ACS)经皮冠状动脉介入治疗(PCI)围手术期C反应蛋白(CRP)和心功能的影响。方法将2018年1月—2019年1月于我院行PCI术的80例ACS患者纳入研究,随机分成两组,对照组40例给予西医常规治疗,观察组40例在对照组的基础上给予替格瑞洛治疗。比较患者的C反应蛋白(CRP)与脑尿钠肽(BNP);血小板聚集率;心功能;不良事件发生率;临床综合疗效。结果两组患者用药后CRP、BNP含量有所下降,观察组明显低于对照组(P <0. 05);两组患者用药后血小板聚集率下降,观察组血小板聚集率低于对照(P <0. 05);观察组术后左室射血分数(EF)大于对照组,左室舒张末期内径(LVEDD)小于对照组,差异有统计学意义(P <0. 05);观察组不良事件发生率低于对照组,差异显著(P <0. 05);观察组治疗总有效率为85%,高于对照组的60%,差异显著(P <0. 05)。结论替格瑞洛对经皮冠状动脉介入治疗的急性冠脉综合征患者的疗效显著,对围手术期C反应蛋白和心功能产生了积极的影响,具有一定的临床意义。
Objective To investigate the effect of tigrilol on C-reactive protein( CRP) and cardiac function in patients with acute coronary syndrome( ACS) undergoing percutaneous coronary intervention( PCI) for( PCI). Methods From January 2018 to January 2019,80 patients with ACS who underwent PCI in our hospital were randomly divided into two groups:control group( n = 40) were treated with conventional western medicine,and observation group( n = 40) were treated with tigrilol on the basis of control group. C-reactive protein( CRP) and brain natriuretic peptide( BNP),platelet aggregation rate,cardiac function,incidence of adverse events and clinical efficacy were compared. Results The levels of CRP and BNP in the two groups decreased after treatment,and the platelet aggregation rate in the observation group was lower than that in the control group( P < 0. 05); the left ventricular ejection fraction( EF) in the observation group was higher than that in the control group,and the left ventricular end-diastolic diameter( LVEDD) was lower than that in the control group( P < 0. 05). The incidence of adverse events in the observation group was lower than that in the control group( P < 0. 05),and the total effective rate in the observation group was 85%,higher than that in the control group( 60%,P < 0. 05). Conclusion Tigrillo has a significant effect on patients with acute coronary syndrome treated by percutaneous coronary intervention,and has a positive effect on C-reactive protein and cardiac function during perioperative period,which has a certain clinical significance.
Objective To investigate the effect of tigrilol on C-reactive protein( CRP) and cardiac function in patients with acute coronary syndrome( ACS) undergoing percutaneous coronary intervention( PCI) for( PCI). Methods From January 2018 to January 2019,80 patients with ACS who underwent PCI in our hospital were randomly divided into two groups:control group( n = 40) were treated with conventional western medicine,and observation group( n = 40) were treated with tigrilol on the basis of control group. C-reactive protein( CRP) and brain natriuretic peptide( BNP),platelet aggregation rate,cardiac function,incidence of adverse events and clinical efficacy were compared. Results The levels of CRP and BNP in the two groups decreased after treatment,and the platelet aggregation rate in the observation group was lower than that in the control group( P < 0. 05); the left ventricular ejection fraction( EF) in the observation group was higher than that in the control group,and the left ventricular end-diastolic diameter( LVEDD) was lower than that in the control group( P < 0. 05). The incidence of adverse events in the observation group was lower than that in the control group( P < 0. 05),and the total effective rate in the observation group was 85%,higher than that in the control group( 60%,P < 0. 05). Conclusion Tigrillo has a significant effect on patients with acute coronary syndrome treated by percutaneous coronary intervention,and has a positive effect on C-reactive protein and cardiac function during perioperative period,which has a certain clinical significance.
引文
[1]张克清,戴珍,贾海莲.祛瘀化痰宁心汤联合西药治疗急性冠脉综合征经皮冠状动脉介入术后心绞痛45例临床观察[J].中医杂志,2018,59(22):1943-1947.
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[3]汪建波,黄瑞,王振华.氯吡格雷联合低分子肝素钠治疗中老年急性冠脉综合征的疗效观察[J].实用临床医药杂志,2018,22(7):107-109,113.
[4]高斯德,李虹伟.糖基化终末产物及其受体在急性冠状动脉综合征中预测价值的研究进展[J].中国心血管杂志,2017,22(6):452-456.
[5]刘首明,夏慧,江小萍,等.缺血性修饰白蛋白、高敏肌钙蛋白Ⅰ及超敏C反应蛋白在急性冠状动脉综合征早期诊断中的价值[J].现代医院,2015,15(8):81-83.
[6]宋伟,林祖近,蔡海鹏.阿司匹林、氯吡格雷联合替罗非班对行PCI急性冠脉综合征患者血小板活性及预后的影响[J].中国医药导报,2018,15(14):47-49,66.
[7]孟祥旭,滕伟,惠学志.左西孟旦对急性冠脉综合征合并急性心力衰竭的作用研究现况[J].心血管病学进展,2018,39(3):394-397.
[8]梁家志,陈志勇,张志广,等.急性冠脉综合征患者PCT水平及临床预后分析[J].现代医院,2017,17(8):1205-1206.
[9]姜荣泸,李正义.急性冠状动脉综合征患者PCI术后长期应用替格瑞洛抗血小板治疗的疗效及安全性观察[J].解放军医药杂志,2017,29(12):36-38,45.
[10]李秀芬,杨敏全,帕尔哈提·吐尔逊.急性冠状动脉综合征负荷量替格瑞洛诱发急性左心衰竭8例[J].中国循环杂志,2017,32(12):1234.
[11]闫杰.替格瑞洛与氯吡格雷对急性冠脉综合征行PCI术后患者血小板功能的影响[J].中国现代药物应用,2018,12(17):88-90.
[12]王娉娉.两种药物对急性冠脉综合征患者经皮冠状动脉介入术后血小板功能和炎性因子的影响对比[J].当代医学,2018,24(28):166-168.
[13]姜荣泸,李正义.急性冠状动脉综合征患者PCI术后长期应用替格瑞洛抗血小板治疗的疗效及安全性观察[J].解放军医药杂志,2017,29(12):36-38,45.
[14]周倩,李谌,蒋薇薇.替格瑞洛和氯吡格雷在急性冠脉综合征PCI术后患者中的应用对比[J/OL].当代医学,2019(4):164-166[2019-01-30].
[15]苏锦文,李新明.氯吡格雷联合阿司匹林对急性冠状动脉综合征患者血清高迁移率族蛋白B1水平的影响[J].山西医药杂志,2018,47(24):2941-2943.
[16]吕萍,毛桂玉,温连安.替格瑞洛和氯吡咯雷抗血小板治疗急性冠脉综合征的临床疗效比较研究[J].中国医药科学,2018,8(2):27-29.
[17]梁茜,王蔚,杨希立,等.急性冠脉综合征合并糖尿病PCI患者CYP2C19基因多态性与替格瑞洛疗效的相关性[J].实用医学杂志,2017,33(19):3276-3280.
[2]王品晓,张云霞,项晓觉,等.急性冠脉综合征患者血尿酸水平变化及与同型半胱氨酸、T细胞亚群、血脂的关系研究[J].中华全科医学,2017,15(9):1512-1514.
[3]汪建波,黄瑞,王振华.氯吡格雷联合低分子肝素钠治疗中老年急性冠脉综合征的疗效观察[J].实用临床医药杂志,2018,22(7):107-109,113.
[4]高斯德,李虹伟.糖基化终末产物及其受体在急性冠状动脉综合征中预测价值的研究进展[J].中国心血管杂志,2017,22(6):452-456.
[5]刘首明,夏慧,江小萍,等.缺血性修饰白蛋白、高敏肌钙蛋白Ⅰ及超敏C反应蛋白在急性冠状动脉综合征早期诊断中的价值[J].现代医院,2015,15(8):81-83.
[6]宋伟,林祖近,蔡海鹏.阿司匹林、氯吡格雷联合替罗非班对行PCI急性冠脉综合征患者血小板活性及预后的影响[J].中国医药导报,2018,15(14):47-49,66.
[7]孟祥旭,滕伟,惠学志.左西孟旦对急性冠脉综合征合并急性心力衰竭的作用研究现况[J].心血管病学进展,2018,39(3):394-397.
[8]梁家志,陈志勇,张志广,等.急性冠脉综合征患者PCT水平及临床预后分析[J].现代医院,2017,17(8):1205-1206.
[9]姜荣泸,李正义.急性冠状动脉综合征患者PCI术后长期应用替格瑞洛抗血小板治疗的疗效及安全性观察[J].解放军医药杂志,2017,29(12):36-38,45.
[10]李秀芬,杨敏全,帕尔哈提·吐尔逊.急性冠状动脉综合征负荷量替格瑞洛诱发急性左心衰竭8例[J].中国循环杂志,2017,32(12):1234.
[11]闫杰.替格瑞洛与氯吡格雷对急性冠脉综合征行PCI术后患者血小板功能的影响[J].中国现代药物应用,2018,12(17):88-90.
[12]王娉娉.两种药物对急性冠脉综合征患者经皮冠状动脉介入术后血小板功能和炎性因子的影响对比[J].当代医学,2018,24(28):166-168.
[13]姜荣泸,李正义.急性冠状动脉综合征患者PCI术后长期应用替格瑞洛抗血小板治疗的疗效及安全性观察[J].解放军医药杂志,2017,29(12):36-38,45.
[14]周倩,李谌,蒋薇薇.替格瑞洛和氯吡格雷在急性冠脉综合征PCI术后患者中的应用对比[J/OL].当代医学,2019(4):164-166[2019-01-30].
[15]苏锦文,李新明.氯吡格雷联合阿司匹林对急性冠状动脉综合征患者血清高迁移率族蛋白B1水平的影响[J].山西医药杂志,2018,47(24):2941-2943.
[16]吕萍,毛桂玉,温连安.替格瑞洛和氯吡咯雷抗血小板治疗急性冠脉综合征的临床疗效比较研究[J].中国医药科学,2018,8(2):27-29.
[17]梁茜,王蔚,杨希立,等.急性冠脉综合征合并糖尿病PCI患者CYP2C19基因多态性与替格瑞洛疗效的相关性[J].实用医学杂志,2017,33(19):3276-3280.