摘要
目的 探讨盐酸替罗非班联合氯吡格雷治疗不稳定型心绞痛的临床效果。方法 90例不稳定型心绞痛患者,采用随机数字抽签法分为对照组和观察组,每组45例。两组患者均行常规综合治疗,在此基础上,对照组患者行氯吡格雷治疗,观察组患者行盐酸替罗非班联合氯吡格雷治疗。比较两组患者临床效果、心血管不良事件发生情况及治疗前后血液流变学指标[全血高切粘度(HBV)、全血低切粘度(LBV)、血浆粘度(PV)、纤维蛋白原(FIB)]、血清炎性因子[白细胞介素-6(IL-6)、可溶性细胞间粘附分子1(sICAM-1)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)]。结果 观察组患者治疗总有效率为95.56%,高于对照组的80.00%,差异具有统计学意义(P<0.05)。治疗后,观察组患者HBV、LBV、PV、FIB水平分别为(4.22±0.72)mPa·s、(10.25±2.24)mPa·s、(1.35±0.23)mPa·s、(4.05±0.51)g/L,均低于对照组的(5.42±1.03)mPa·s、(13.03±2.76)mPa·s、(1.54±0.25)mPa·s、(4.48±0.57)g/L,差异具有统计学意义(P<0.05)。治疗后,观察组患者IL-6、sICAM-1、TNF-α、hs-CRP水平分别为(25.54±5.45)pg/ml、(212.23±25.94)μg/L、(6.15±1.78)ng/ml、(9.84±2.43)mg/L,均低于对照组的(36.62±6.76)pg/ml、(268.45±30.18)μg/L、(9.93±2.15)ng/ml、(15.73±3.11)mg/L,差异具有统计学意义(P<0.05)。观察组患者心血管不良事件发生率为2.22%,低于对照组的13.33%,差异具有统计学意义(P<0.05)。结论 针对不稳定型心绞痛患者采取盐酸替罗非班联合氯吡格雷治疗可有效降低血清炎性因子水平,改善血液流变学指标,快速消除临床症状,恢复正常心电图,提高治疗效果,并且可预防心血管不良事件发生,值得推广应用。
Objective To discuss the clinical effect of tirofiban hydrochloride combined with clopidogrel in the treatment of unstable angina pectoris.Methods A total of 90 patients with unstable angina pectoris were randomly divided into control group and observation group by random number drawing,with 45 cases in each group.Both groups received conventional comprehensive treatment,on this basis,the control group was treated with clopidogrel,and the observation group was treated with tirofiban hydrochloride combined with clopidogrel.Both groups were compared in terms of clinical effect,the occurrence of adverse cardiovascular events,and the hemorheology indexes[high blood viscosity(HBV),low blood viscosity(LBV),plasma viscosity(PV),fibrinogen(FIB)],serum inflammatory factors[interleukin-6(IL-6),soluble intercellular adhesion molecule-1(sICAM-1),tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP)]before and after treatment.Results The total effective rate in the observation group was 95.56%,which was higher than 80.00%in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of HBV,LBV,PV,and FIB in the observation group were(4.22±0.72)mPa·s,(10.25±2.24)mPa·s,(1.35±0.23)mPa·s,and(4.05±0.51)g/L,which were lower than(5.42±1.03)mPa·s,(13.03±2.76)mPa·s,(1.54±0.25)mPa·s,and(4.48±0.57)g/L in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of IL-6,sICAM-1,TNF-α,and hs-CRP in the observation group were(25.54±5.45)pg/ml,(212.23±25.94)μg/L,(6.15±1.78)ng/ml,and(9.84±2.43)mg/L,which were lower than(36.62±6.76)pg/ml,(268.45±30.18)μg/L,(9.93±2.15)ng/ml,and(15.73±3.11)mg/L in the control group,and the differences were statistically significant(P<0.05).The incidence of cardiovascular adverse events in the observation group was 2.22%,which was lower than 13.33%in the control group,and the difference was statistically significant(P<0.05).Conclusion In patients with unstable angina pectoris,treatment with tirofiban hydrochloride combined with clopidogrel can effectively reduce serum inflammatory factor levels,improve hemorheology indexes,rapidly eliminate clinical symptoms,restore normal electrocardiogram,improve the therapeutic effect,and prevent cardiovascular adverse events,which is worthy of promotion and application.
作者
黄家中
HUANG Jia-zhong(Fuxin Mine General Hospital of Liaoning Health Industry Group,Fuxin 123000,China)
出处
《中国现代药物应用》
2022年第14期13-16,共4页
Chinese Journal of Modern Drug Application
