经桡动脉入路PCI联合双联抗血小板对冠心病患者心功能、血管内皮功能、冠状动脉再狭窄的改善作用

Improved effect of PCI combined with dual antiplatelet via radial artery approach on cardiac function,vascular endothelial function,and coronary restenosis in patients with coronary heart disease

目的观察经桡动脉入路经皮冠状动脉介入术(PCI)联合双联抗血小板对冠心病患者心功能、血管内皮功能、冠状动脉再狭窄的改善作用。方法选取2019年6月—2020年6月四川省攀枝花市中心医院心血管内科诊治冠心病患者104例,按照随机数字表法分为对照组与观察组,各52例。对照组在经桡动脉入路PCI术后进行常规治疗,观察组在对照组基础上增加双联抗血小板治疗(氯吡格雷片和阿司匹林肠溶片)。超声检查2组患者LVEF、LVEDD、LVESD指标,实验室检测血ET-1、NO、TXB2、PT、TT、APTT、VEGF、IL-6、CRP水平,并进行比较。结果治疗后,与对照组比较,观察组LVEF升高,LVEDD、LVESD降低(t/P=7.707/0.001、4.670/0.001、5.247/0.001);ET-1、TXB2水平均降低,NO水平升高(t/P=5.309/0.001、5.241/0.001、5.602/0.001);PT、TT、APTT指标均升高(t/P=7.037/0.001、7.002/0.001、18.290/0.001);VEGF水平升高,IL-6、CRP水平降低(t/P=10.160/0.001、11.230/0.001、74.180/0.001);血小板聚集率及冠状动脉再狭窄发生率均较低(χ^(2)/P=4.981/0.025、3.983/0.045)。结论经桡动脉入路PCI联合双联抗血小板对冠心病患者进行治疗,能够改善患者心功能,减少内皮损伤,降低血栓形成及冠状动脉再狭窄的发生,同时降低炎性反应,效果明显。

Objective To observe the effect of transradial percutaneous coronary intervention(PCI)combined with dual antiplatelet on the cardiac function,vascular endothelial function,and coronary restenosis in patients with coronary heart disease.Methods From June 2019 to June 2020,104 patients with coronary heart disease were diagnosed and treated in the Department of Cardiology,Panzhihua Central Hospital,Sichuan Province,and were divided into a control group and an observation group according to a random number table,with 52 cases in each group.The control group received conventional treatment after PCI via radial artery approach,and the observation group added dual antiplatelet therapy(clopidogrel tablets and aspirin enteric-coated tablets)to the control group.The LVEF,LVEDD,and LVESD indexes of the 2 groups were examined by ultrasound,and the blood ET-1,NO,TXB2,PT,TT,APTT,VEGF,IL 6,and CRP levels were tested in the laboratory and compared.Results After treatment,compared with the control group,the observation group LVEF increased,LVEDD and LVESD decreased(t/P=7.707/0.001,4.670/0.001,5.247/0.001);ET-1,TXB2 levels decreased,and NO levels increased(t/P=5.309/0.001,5.241/0.001,5.602/0.001);PT,TT,APTT indicators all increased(t/P=7.037/0.001,7.002/0.001,18.290/0.001);VEGF level increased,IL 6.The level of CRP decreased(t/P=10.160/0.001,11.230/0.001,74.180/0.001);the platelet aggregation rate and the incidence of coronary artery restenosis were lower(χ^(2)/P=4.981/0.025,3.983/0.045).Conclusion Transradial PCI combined with dual antiplatelet therapy for patients with coronary heart disease can improve the patient's heart function,reduce endothelial damage,reduce thrombosis and coronary restenosis,and reduce the inflammatory response.