通心络胶囊联合双抗血小板方案对PCI术后阿司匹林抵抗患者预后的影响

Effect of Tongxinluo Capsule combined with Dual Antiplatelet Regimen on the Prognosis of Patients with Aspirin Resistance after PCI

目的:探讨通心络胶囊联合双抗血小板方案对经皮冠脉介入术(PCI)后阿司匹林抵抗(AR)患者预后的影响。方法:选择2012年2月至2016年4月于我院行PCI治疗术后伴AR的100例冠心病患者作为研究对象,按随机数字表法分为对照组与观察组各50例,对照组行双抗血小板方案治疗,观察组在此基础上加用通心络胶囊治疗,用药不同时间均测定患者血小板聚集程度、血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)水平,采用心脏超声测定患者心功能的变化,观察其心绞痛症状的改善情况,两组均随访1年,统计不良心血管事件发生率。结果:用药4周,两组血小板聚集率均有不同程度的降低(P<0.05),观察组AA、ADP诱导血小板聚集率低于对照组(P<0.05);用药前,两组血脂及心功能指标比较差异无统计学意义(P>0.05),用药6个月,两组TC、TG、LDL、LVESD均降低,HDL、LVEF上升(P<0.05),观察组TC、TG、LDL、LVESD低于对照组,HDL、LVEF高于对照组(P<0.05);用药6、12个月,两组心绞痛评分均上升,观察组用药不同时间评分均高于对照组(P<0.05);观察组随访1年各不良事件发生率均略低于对照组,但仅心绞痛再入院率比较差异有统计学意义(P<0.05)。结论:通心络胶囊联合双抗血小板方案可改善PCI术后患者患者阿司匹林抵抗,改善患者血脂水平及心功能,改善心绞痛症状,降低心血管不良事件发生率,有利于改善患者预后。

Objective:To explore the effect of Tongxinluo capsule combined with dual antiplatelet regimen on the prognosis of patients with aspirin resistance(AR)after percutaneous coronary intervention(PCI).Methods:100 patients with coronary heart disease(CHD)who had AR after undergoing PCI in the hospital from February 2012 to April 2016 were selected as the subjects.They were randomly divided into the control group and the observation group by the random number table method,50 cases in each group.The control group was treated with dual antiplatelet regimen,and on the basis,the observation group was treated with Tongxinluo capsule.The degree of platelet aggregation,serum total cholesterol(TC),triglyceride(TG),low-density lipoprotein(LDL)and high-density lipoprotein(HDL)levels were measured at different time.Changes of cardiac function in patients were determined by echocardiography,and the relief of symptoms of angina pectoris was observed.The two groups were followed up for 1 year,and the incidence of adverse cardiovascular events was statistically analyzed.Results:After 4 weeks of treatment,the platelet aggregation rates of the two groups decreased to varying degrees(P<0.05),and the platelet aggregation rates induced by AA and ADP in the observation group were lower than those in the control group(P<0.05).Before treatment,there was no significant difference between the two group in serum lipids or cardiac function indexes(P>0.05).After 6 months of treatment,the TC,TG,LDL and LVESD in the two groups were decreased,while HDL and LVEF were increased(P<0.05).The TC,TG,LDL and LVESD in the observation group were lower than those in the control group while HDL and LVEF were higher than those in the control group(P<0.05).The scores of angina pectoris in the two groups were increased after 6 and 12 months of treatment,and the scores of the observation group were higher than those of the control group(P<0.05).The incidence of adverse events in the observation group during 1-year follow-up was slightly lower than that in the control group,but there was a significant difference only in the readmission rate(P<0.05).Conclusion:Tongxinluo capsule combined with dual antiplatelet regimen can improve the blood lipid levels and cardiac function,relieve angina pectoris symptoms,reduce the incidence of cardiovascular adverse events,and improve the prognosis of patients with AR after PCI.