吲哚布芬联合氯吡格雷在经皮冠状动脉介入治疗术后非瓣膜性心房颤动中的应用效果

The effect of indobufen combined with clopidogrel in the treatment of non valvular atrial fibrillation after percutaneous coronary intervention

目的探讨吲哚布芬联合氯吡格雷在经皮冠状动脉介入治疗(PCI)术后非瓣膜性心房颤动(NVAF)中的应用效果。方法选取2017年7月—2018年10月于聊城市第二人民医院心内科行PCI术后出现NVAF的患者28例,随机分为对照组15例,观察组13例。两组均给予常规治疗,对照组术后服用阿司匹林联合氯吡格雷,试验组术后服用吲哚布芬联合氯吡格雷,并根据INR调整华法林用量。两组均进行6个月的观察。比较两组术后1、6个月后缺血性脑卒中发生率、心肌缺血未改善率、不良事件发生率、血栓弹力图AA途径抑制率。结果术后1个月,两组缺血性脑卒中发生率、心肌缺血未改善率、血栓弹力图AA途径抑制率比较,差异无统计学意义(P>0.05)。试验组不良事件发生率低于对照组(P<0.05)。术后6个月,两组缺血性脑卒中发生率比较,差异无统计学意义(P>0.05);试验组血栓弹力图AA途径抑制率与术后1个月相比,差异无统计学意义(P>0.05);试验组心肌缺血未改善率和不良事件发生率低于对照组(P<0.05)。结论吲哚布芬联合氯吡格雷在PCI术后NVAF中的应用效果良好,能达到抗血小板和抗凝的双重目的,且安全性较高。

Objective To investigate the effect of indobufen combined with clopidogrel in the treatment of non valvular atrial fibrillation(NVAF)after percutaneous coronary intervention(PCI).Methods A total of 28 cases of patients who underwent PCI and NVAF were selected from July 2017 to October 2018 in the Department of Internal MedicineCardiovascular,the Second People’s Hospital of Liaocheng,which were randomly divided into control group(n=15)and experimental group(n=13).Both groups were given routine treatment,the control group took aspirin combined with clopidogrel,the experimental group took indobufen combined with clopidogrel,and the dosage of warfarin was adjusted according to INR.Both groups were observed for 6 months.The incidence rate of ischemic stroke,no improvement of myocardial ischemia,adverse events and inhibition of AA pathway of thromboelastogram were compared between the two groups one month and six mouth after operation.Results One month after operation,there was no significant difference between the two groups in the incidence rate of ischemic stroke,no improvement of myocardial ischemia and inhibition of AA pathway of thromboelastogram(P>0.05).The incidence rate of adverse events in the experimental group was lower than the control group(P<0.05).Six months after operation,there was no significant difference in the incidence rate of ischemic stroke between the two groups(P>0.05);there was no significant difference in the inhibition rate of AA pathway of thromboelastogram between the experimental group and one month after operation(P>0.05);the incidence rate of adverse events in the experimental group were lower than the control group(P<0.05).Conclusion The combination of no improvement of myocardial ischemia and ibuprofen and clopidogrel in the treatment of NVAF after PCI has a good effect,it can achieve the dual purpose of antiplatelet and anticoagulation,and with high safety.