比较吲哚布芬与阿司匹林联合氢氯吡格雷在急性冠脉综合征介入治疗后的应用效果及安全性

Comparison of application effects and safety of indobufen and aspirin separately combined with clopidogrel after interventional treatment of acute coronary syndrome

目的比较吲哚布芬与阿司匹林联合氢氯吡格雷在急性冠脉综合征(acute coronary syndrome,ACS)介入治疗后的应用效果及安全性。方法选取2020年9月至2021年8月于九江市第一人民医院行介入治疗后的96例ACS患者作为研究对象,按照随机数字表法分为观察组与对照组,每组48例。观察组给予吲哚布芬联合氢氯吡格雷治疗,对照组给予阿司匹林联合氢氯吡格雷治疗,比较两组临床疗效和治疗前后血清因子水平、心功能指标、血小板相关指标及主要不良心血管事件(major adverse cardiovascular events,MACE)、药物不良反应(adverse drug reaction,ADR)发生情况。结果观察组治疗总有效率为95.83%,高于对照组的81.25%,差异有统计学意义(P<0.05)。治疗后,观察组血清白细胞介素-6(interleukin-6,IL-6)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平均低于对照组,白细胞介素-35(interleukins-35,IL-35)水平高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组左心室收缩末期内径(left ventricular end systolic diameter,LVESD)、左心室舒张末期内径(left ventricular end diastolic diameter,LVEDD)均短于对照组,左心室射血分数(left ventricular ejection fraction,LVEF)高于对照组,氨基末端B型脑钠肽(N-terminal pro-brain natriuretic peptide,NT-proBNP)水平低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组血小板计数、血小板分布宽度、血小板聚集率均低于对照组,血小板体积小于对照组,差异有统计学意义(P<0.05)。观察组MACE发生率为12.50%,低于对照组的29.17%,差异有统计学意义(P<0.05)。观察组ADR发生率为6.25%,低于对照组的20.83%,差异有统计学意义(P<0.05)。结论吲哚布芬联合氢氯吡格雷在ACS介入治疗后的应用效果显著,可改善血清因子水平、心功能,有效抑制血小板聚集,降低MACE、ADR发生率,安全性较高。

Objective To compare application effects and safety of indobufen and aspirin separately combined with clopidogrel after interventional treatment of acute coronary syndrome(ACS).Methods A total of 96 patients with ACS who underwent interventional treatment at Jiujiang NO.1 People's Hospital from September 2020 to August 2021 were selected as the study subjects,and they were divided to the observation group and the control group according to the random number table method,with 48 cases in each group.The observation group was treated with indobuprofen combined with hydroclopidogrel,and the control group was treated with aspirin combined with hydroclopidogrel.The clinical efficacy,serum factor levels,cardiac function indexes,platelet-related indexes before and after treatment and major adverse cardiovascular events(MACE)and adverse drug reaction(ADR)were compared between the two groups.Results The total effective rate in the observation group was 95.83%,which was higher than 81.25%in the control group,the difference was statistically significant(P<0.05).After treatment,serum interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α)levels in the observation group were lower than those in the control group,and the level of interleukin-35(IL-35)was higher than that in the control group,and the differences were statistically significant(P<0.05).After treatment,left ventricular end systolic diameter(LVESD)and left ventricular end diastolic diameter(LVEDD)in the observation group were shorter than those in the control group,left ventricular ejection fraction(LVEF)was higher than that in the control group,and the level of N-terminal pro-brain natriuretic peptide(NT-proBNP)was lower than that in the control group,the differences were statistically significant(P<0.05).After treatment,platelet count,platelet distribution widthand platelet aggregation rate in the observation group were lower than those in the control group,and platelet volume was smaller than that in the control group,the differences were statistically significant(P<0.05).The incidence rates of MACE and ADR in the observation group were 12.50%and 6.25%,which were lower than 29.17%and 20.83%in the control group,the differences were statistically significant(P<0.05).Conclusion Indobufen combined with clopidogrel can achievesignificant therapeutic effects after interventional treatment of ACS,which can improve serum factor levels and cardiac function indicators,effectively inhibit platelet aggregation,and reduce the incidence of MACE and ADR,with high safety.