西洛他唑应用于心肌梗死冠状动脉介入患者治疗效果及其安全性探讨

Study on efficacy and safety of cilostazol in treatment of patients with myocardial infarction undergoing coronary intervention

目的探讨西洛他唑应用于心肌梗死冠状动脉介入患者治疗效果及其安全性。方法选取94例心肌梗死患者作为研究对象,随机分为观察组和对照组,每组各47例。两组患者均行冠状动脉介入手术治疗,术前口服硫酸氢氯吡格雷片、阿司匹林肠溶片,术后给予他汀类、血管转换酶抑制剂、硝酸酯类、β-受体阻滞剂等常规治疗。对照组在常规治疗基础上给予硫酸氢氯吡格雷片75毫克/次,1次/天;阿司匹林肠溶片100毫克/次,1次/天;观察组在对照组治疗基础上加用西洛他唑片200毫克/次,1次/天。两组患者疗程为1个月。比较两组患者血清肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、超敏肌钙蛋白T(hs-cTnT)、肌酸激酶同工酶(CK-MB)、血小板聚集率、血小板计数(PLT)、左心室舒张末内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)水平变化情况,并记录两组患者心血管事件发生率。结果观察组TNF-α、hsCRP、IL-6、hs-cTnT、CK-MB、血小板聚集率、LVEDD、LVESD水平明显低于对照组,LVEF明显高于对照组,差异均有统计学意义(P<0.05);观察组血管再狭窄、再次血运重建、再发心肌梗死、恶性心律失常、心力衰竭、死亡等主要心血管发生率明显低于对照组,差异有统计学意义(P<0.05)。结论西洛他唑能够减轻心肌梗死冠状动脉介入患者炎性反应症状,抑制血小板活化,有效降低心血管不良事件发生率,安全可靠,有利于改善患者预后。

Objective To investigate the efficacy and safety of cilostazol in the treatment of the patients with myocardial infarction（MI）undergoing coronary intervention.Methods Ninety-four cases of myocardial infarction were selected and randomly divided into the observation group and control group,47 cases in each group.The two groups all were treated with coronary intervention operation,clopidogrel tablets and aspirin enteric-coated tablets were administered prior to surgery,and the postoperative conventional therapy such statins,vascular conversion enzyme inhibitors,nitrates andβ-blockers were performed.On the basis of conventional therapy,the control group was given clopidogrel hydrogen sulfate tablets 75 mg per time,once daily and aspirin enteric-coated tablets 100 mg per time,once daily;on the basis of the control group,the observation group was added with cilostazol tablets 200 mg per time,once daily.The treatment course in the two groups lasted for 1month.The changes of tumor necrosis factor-α（TNF-α）,high-sensitivity C-reactive protein（hs-CRP）,interleukin-6（IL-6）,high-sensitivity troponin（hs-cTnT）,creatine kinase-MB（CKMB）,platelet aggregation rate,platelets（PLT）,left ventricular end diastolic diameter（LVEDD）,left ventricular end systolic diameter（LVESD）and left ventricular ejection fraction（LVEF）levels were compared between the two groups.The incidence rates of main adverse cardiovascular events（MACE）were recorded in the two groups.Results The levels of TNF-α,hs-CRP,IL-6,hs-cTnT,CK-MB,platelet aggregation rate,LVEDD and LVESD after treatment in the observation group were significantly lower than those in the control group,while the LVEF level was significantly higher than that in the control group,the differences were statistically significant（P〈0.05）;the occurrence rate of MACE such as vascular restenosis,revascularization,recurrent myocardial infarction,malignant arrhythmia,heart failure and death occurred in the observation group was significantly lower than that in the control group,the difference was statistically significant（P〈0.05）.Conclusion Cilostazol can reduce the inflammatory symptoms in the patients with myocardial infarction undergoing coronary intervention,inhibits the platelet activation,effectively reduces the incidence rate of MACE,is also safe and reliable,and helps to improve the prognosis of patients.