氯吡格雷预防冠心病介入治疗后心血管不良事件效果观察

Efficacy of clopidogrel in prevention of adverse cardiovascular events after interventional treatment in patients with coronary heart disease

目的探索冠心病患者介入治疗后预防性应用氯吡格雷对其心血管不良事件的干预效果。方法将2021年4月—2023年4月于青海红十字医院行冠心病介入治疗的112例患者作为研究对象,采用随机数字表法将所有患者平均分为噻氯匹定组与氯吡格雷组,每组56例。噻氯匹定组患者预防性应用噻氯匹定治疗,氯吡格雷组患者预防性应用氯吡格雷治疗,比较两组患者的心血管不良事件发生率、临床效果、治疗前与治疗24 h后血小板聚集率与血栓素B2指标变化、治疗满意度。结果氯吡格雷组患者心血管不良事件发生率(3.57%)低于噻氯匹定组(14.29%),治疗总有效率(96.43%)高于噻氯匹定组(86.71%)(χ^(2)=3.9529,P=0.0468;χ^(2)=3.9529,P=0.0468);两组患者凝血功能指标比较差异无统计学意义(P>0.05);治疗前两组患者血栓素B2及血小板聚集率比较差异无统计学意义(P>0.05);治疗24 h后两组患者血栓素B2及血小板聚集率均下降,氯吡格雷组患者治疗24 h后血栓素B2[(42.38±6.23)pg·mL^(-1)vs(66.23±5.72)pg·mL^(-1)]及血小板聚集率[(25.39±4.17)pg·mL^(-1)vs(30.26±3.76)pg·mL^(-1)]低于噻氯匹定组(t=3.2581,P=0.0253);氯吡格雷组患者治疗满意率(92.86%)高于噻氯匹定组(78.57%)(χ^(2)=4.6667,P=0.0308)。结论冠心病介入治疗患者预防性应用氯吡格雷可较好预防患者术后发生心血管不良事件,提升治疗效果,患者较为认可。

Objective To investigate the clinical effect of prophylactic application of clopidogrel on cardiovascular adverse events in patients with coronary heart disease after interventional treatment.Methods A total of 112 patients recieving coronary intervention treatment in our hospital from April 2021 to April 2023 were enrolled in this study.These patients were randomized into the thiacloprid group and the clopidogrel group,with 56 in each.The patients in the ticlopidine group received prophylactic treatment with ticlopidine,and those in the clopidogrel group received prophylactic treatment with clopidogrel.The incidence of cardiovascular adverse events,clinical effects,changes in platelet aggregation rate and thrombin B2 index before and 24 h after treatment,and treatment satisfaction rate were compared bwteen the 2 groups.Results The incidence of cardiovascular adverse events(3.57%)was lower but the total effective rate(96.43%)higher in the clopidogrel group than in the ticlopidine group(14.29%)(86.71%)(χ^(2)=3.9529,P=0.0468;χ^(2)=3.9529,P=0.0468).There was no statistically significant difference in coagulation function indicators between 2 groups(P>0.05).There was no statistically remarkable difference in thromboxane B2 and platelet aggregation rate between two groups before treatment(P>0.05).Thromboxane B2 and platelet aggregation rate decreased in both groups after 24 h of treatment,and patients in the clopidogrel group had lower thromboxane B2[(42.38±6.23)pg·mL^(-1)vs.(66.23±5.72)pg·mL^(-1)]and platelet aggregation rate[(25.39±4.17)pg·mL^(-1)vs.(30.26±3.76)pg·mL^(-1)]as compared to the ticlopidine group after 24 h of treatment(t=3.2581,P=0.0253).The satisfaction rate of clopidogrel group(92.86%)was higher than that of ticlopidine group(78.57%)(χ^(2)=4.6667,P=0.0308).Conclusion The prophylactic application of clopidogrel after interventional therapyin patients with coronary heart disease can better prevent cardiovascular adverse events and improve the therapeutic effect.Therefore,most of the patients accept it.