替格瑞洛对冠状动脉粥样硬化性心脏病支架术后患者脑钠肽 心率及心肌酶谱的影响

Effect of tiglielo on BNP,HR and myocardial enzyme spectra after coronary artery bypass grafting

目的探讨替格瑞洛对冠状动脉粥样硬化性心脏病(冠心病)行支架治疗术后患者脑钠肽(BNP)、心率(HR)及心肌酶谱的影响。方法选取2017年1月至2017年8月在安徽省第二人民医院接受支架介入术的冠心病患者84例为研究对象,按照随机数字表法分为观察组和对照组,每组各42例。对照组患者于冠状动脉介入治疗术后予以口服氯吡格雷治疗,观察组患者冠状动脉介入治疗术后予以口服替格瑞洛治疗。两组患者均连续治疗6个月,6个月后复诊并比较治疗后两组患者血浆BNP、HR、心肌酶谱指标、炎症指标[白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)及C反应蛋白(CRP)]水平变化及心脏不良事件发生情况。结果治疗6个月后,观察组患者血浆BNP、HR、肌酸激酶同工酶(CK-MB)、肌钙蛋白(c Tn I)、IL-6、TNF-α、CRP降低水平均高于对照组,差异有统计学意义(P<0.05);观察组患者心脏不良事件发生率为2.38%,低于对照组的4.76%,但差异无统计学意义(P=1.000)。结论替格瑞洛可有效降低冠心病支架术后患者血浆BNP、心肌酶水平,有利于控制HR,可有效降低炎症反应,值得临床推广应用。

Objective To study the effects of tiglielo on brain natriuretic peptide （BNP） , heart rate （HR） and myocardial enzyme spectra in patients with coronary heart disease. Methods From Feb 2016 to Dec 2017, 84 patients with coronary heart disease treated by stent intervention were selected as the study subjects. All patients were divided into observation group and control group according to the ran-dom number table method, with 42 cases in each group. The control group was treated by oral clopidogrel after operation, and the observation group was treated with oral tiglielot. The two groups underwent further consultation for 6 months consecutively, and the plasma BNP, HR, myocardial enzyme spectrum index and inflammatory index level changes in two groups before and after treatment, as well as the occurrence of adverse cardiac events were compared. Results The difference between BNP and HR before and after treatment was higher in observation group than in control group, and the difference was statistically significant （all P 〈 0 . 0 5）. The difference of CK - MB and cTnl before and after treatment in observation group was higher than that in control group, and the difference was statistically significant （all P 〈 0 . 0 5） . The incidence of cardiac adverse events in observation group was 2. 38% , which was significantly lower than that in control group （ 4.76% ） , but the difference between the groups was not statistically significant （P = 1 .0 0 0 ）. Conclusion The levels of plasma BNP and myocardial en-zymes in patients with coronary heart disease after coronary heart disease are effectively reduced by streroco, which is beneficial to control the level of HR and effectively reduce the inflammatory reaction. It is worth clinical application.