吲哚布芬联合替格瑞洛对急性心肌梗死介入术后患者短期临床预后的影响分析

Influence of indobufen combined with ticagrelor on short-term prognosis in patients with acute myocardial infarction after interventional therapy

目的观察吲哚布芬联合替格瑞洛对急性心梗死患者经皮冠状动脉介入治疗(PCI)术后短期临床预后的影响。方法选择2018年4月至2020年2月于济源市人民医院收治的155例患者,随机分为对照组79例和观察组76例,对照组给予阿司匹林+替格瑞洛片,观察组给予吲哚布芬片+替格瑞洛片,均治疗4周。比较两组血小板参数血小板计数(PLT)、平均血小板体积(MPV)、血小板压积(PCT),冠状动脉血流参数左前降支收缩期峰流速(SPV)、舒张期峰流速(DPV)、冠状动脉血流储备(CFVR),炎性因子指标白介素6(IL-6)、C反应蛋白(CRP)、可溶性白细胞分化抗原40配体(sCD40L)、肿瘤坏死因子α(TNF-α),记录不良反应。结果与治疗前相比,治疗后两组PLT、IL-6、CRP、sCD40L、TNF-α降低,MPV、SPV、DPV、CFVR升高(P<0.05);且观察组均优于对照组(P<0.05)。观察组不良反应发生率为3.95%,低于对照组的13.92%(P<0.05)。结论急性心梗死患者PCI术后予吲哚布芬联合替格瑞洛,可减轻血小板凝聚,改善冠状动脉血流,降低炎性因子水平。

Objective To observe the influence of indobufen combined with ticagrelor on short-term prognosis in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods The patients(n=155)were chosen from People’s Hospital of Jiyuan City from Apr.2018 to Feb.2020,and divided randomly into control group(n=79)and observation group(n=76).The control group was treated with aspirin and ticagrelor and observation group was treated with indobufen and ticagrelor for 4 weeks.The platelet parameters including platelet count(PLT),mean platelet volume(MPV),plateletcrit(PCT),parameters of coronary flow including systolic peak velocity(SPV),left anterior descending branch(LAD),diastolic peak velocity(DPV)and coronary flow reserve(CFR),and interleukin-6(IL-6),C-reactive protein(CRP),soluble CD40 ligand(sCD40L)and tumor necrosis factor-α(TNF-α)were compared in 2 groups.The adverse reactions were recorded.Results The levels of PLT,IL-6,CRP,sCD40L and TNF-αdecreased,and MPV,SPV,DPV and CFVR increased in 2 groups after treatment(P<0.05),and all results were superior in observation group to those in control group(P<0.05).The incidence rate of adverse reactions was 3.95%in observation group and 13.92%in control group(P<0.05).Conclusion Indobufen combined with ticagrelor can relieve platelet aggregation,improve coronary blood flow and reduce inflammatory factor level in AMI patients after PCI.