吲哚布芬联合氯吡格雷对急性冠状动脉综合征患者经皮冠状动脉介入治疗术后应用研究

Application of indobuprofen combined with clopidogrel in patients with ACS after PCI

目的 探讨吲哚布芬联合氯吡格雷对急性冠状动脉综合征(acute coronary syndrome, ACS)患者经皮冠状动脉介入治疗(PCI)术后治疗的有效性及安全性。方法 选取2020年6月~2022年3月河北中医药大学第二附属医院行PCI治疗ACS患者156例,单双号分为观察组(氯吡格雷联合吲哚布芬)、对组照(氯吡格雷联合阿司匹林),每组78例。记录患者12月内不良心血管事件(MACE)、药物不耐受情况、出血情况,并检测患者血清单核细胞趋化蛋白1(MCP-1)和钙结合蛋白(S100A12)水平。结果 观察组患者临床疗效为80.87%,高于对照组患者的临床疗效62.82%,差异有统计学意义(χ^(2)=6.205,P<0.05);对照组患者12月内有3例卒中、5例心肌梗死和3例心血管死亡,观察组患者12月内有1例卒中、3例心肌梗死和1例心血管死亡,两组比较,差异无统计学意义(χ^(2)=0.291,P> 0.05);对照组患者1例患者出现胃肠道不适、2例患者出现皮疹、1例患者出现哮喘,观察组患者并未明显出现药物耐受情况,观察组患者药物耐受情况优于对照组,差异有统计学意义(P<0.05);对照组患者有5例不重要出血,4例小出血和2例大出血,观察患者有2例不重要出血,2例小出血,并无大出血情况,观察组患者的出血情况低于对照组,差异有统计学意义(χ^(2)=6.281,P<0.05);经过治疗后,观察组患者MCP-1和S100A12水平均低于对照组[(86.39±16.29)pg/ml vs.(134.28±17.04)pg/ml、(23.94±6.93)ng/ml vs.(41.32±8.48)ng/ml],差异有统计学意义(t=17.942、14.016,P<0.05)。结论 吲哚布芬联合氯吡格雷治疗ACS患者PCI术后有效性和安全性良好,其能够有效降低血清MCP-1和S100A12水平。

Objective Studies have confirmed the efficacy and safety of post-operative acute coronary treatment with indomebufen and clopidroid(ACTE coronary syndrome,ACS)in patients with acute coronary syndrome.Methods Between June 2020 to March 2022,156 patients undergoing routine PCI treatment were enrolled,with the single combination divided into control groups(clopidgray endomebofen)and clopidgray aspirin,78 cases per patient group.The serum MCP-1 and S100A12 levels of the patients were measured and their main adverse cardiac events(MACE),drug intolerance and bleeding were recorded within 12 months.Results The clinical effectiveness rate in the observation group was 80.87%,significantly higher than that of control group 62.82%(χ^(2)=6.205,P<0.05).In control group,there were 3 stroke cases,5 myocardial infarction cases and 3 cardiovascular deaths within 12 months.There were 1 stroke,3 myocardial infarction and 1 cardiovascular death in the observation group within 12 months.There were no differences in the two sets of comparisons(χ^(2)=0.291,P>0.05).In one case in the control group,gastrointestinal disorders,in two cases a rash,and in one case asthma,patients in the control group showed no apparent drug tolerance and patients in the control group had better drug tolerance than the control group(P<0.05);There were 5 cases of insignificant bleeding,4 cases of minor bleeding,2 cases of acute bleeding in the control group,2 cases of insignificant bleeding,2 cases of minor bleeding without bleeding,1 case of minor bleeding without bleeding and 1 case of less bleeding than in the control group(χ^(2)=6.281,P<0.05);Patients in the control group after treatment had levels of MCP-1 and S100A12 lower than those in the control group(t=17.942,14.016,P<0.05).Conclusion Post-operative treatment with indomebufen and clopidgray following PCI in patients with ACS is effective and safe,and can effectively reduce serum levels of MCP-1 and S100A12.