氯吡格雷+阿司匹林治疗老年冠心病的临床效果及对血清炎症因子的影响分析

Clinical efficacy of clopidogrel and aspirin in the treatment of senile coronary heart disease and its influence on serum inflammatory factors

目的探究老年冠心病应用氯吡格雷+阿司匹林治疗的临床效果及对血清炎症因子的影响。方法150例老年冠心病患者,随机分为观察组与对照组,各75例。对照组单用阿司匹林治疗,观察组在对照组基础上加用氯吡格雷治疗。比较两组临床疗效、用药前后心功能指标[左心室射血分数(LVEF)、左心室舒张末内径(LVEDD)、左心室收缩末期内径(LVESD)]、血清炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]。结果观察组治疗总有效率97.33%高于对照组的81.33%,差异有统计学意义(P<0.05)。用药后,观察组LVEDD(54.75±5.02)mm、LVESD(38.85±3.26)mm小于对照组的(60.36±5.23)、(46.54±4.15)mm,LVEF(49.36±6.42)%高于对照组的(38.16±4.27)%,差异有统计学意义(P<0.05)。用药后,观察组IL-6、TNF-α、CRP分别为(12.01±1.49)ng/L、(19.98±1.52)mg/L、(2.15±0.09)mg/L,均低于对照组的(17.54±2.52)ng/L、(26.19±2.75)mg/L、(4.14±0.52)mg/L,差异有统计学意义(P<0.05)。结论在老年冠心病患者治疗中氯吡格雷+阿司匹林的效果理想,患者心功能指标及血清炎症因子明显改善,可控制不良反应。

Objective To investigate the clinical effect of clopidogrel and aspirin in the treatment of senile coronary heart disease and its influence on serum levels.Methods A total of 150 senile patients with coronary heart disease were randomly divided into observation group and control group,with 75 cases in each group.The control group was treated with aspirin,and the observation group was treated with clopidogrel based on the control group.The clinical efficacy,cardiac function indicators[left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD)],serum inflammatory factors[interleukin-6(IL-6),tumor necrosis factor alpha(TNF-α),C-reactive protein(CRP)]before and after medication were compared between the two groups.Results The total effective rate 97.33%of the observation group was higher than 81.33%of the control group,and the difference was statistically significant(P<0.05).After medication,LVEDD(54.75±5.02)mm,LVESD(38.85±3.26)mm of the observation group were less than(60.36±5.23),(46.54±4.15)mm of the control group,and LVEF(49.36±6.42)%was higher than(38.16±4.27)%of the control group.All the difference was statistically significant(P<0.05).After medication,IL-6,TNF-αand CRP of the observation group were(12.01±1.49)ng/L,(19.98±1.52)mg/L and(2.15±0.09)mg/L,which were lower than(17.54±2.52)ng/L,(26.19±2.75)mg/L and(4.14±0.52)mg/L of the control group,and the difference was statistically significant(P<0.05).Conclusion Combination of clopidogrel and aspirin has ideal effect on senile patients with coronary heart disease,obviously improve the cardiac function index and serum level of the patients,and control the adverse reactions.