摘要
目的探讨硫酸氢氯吡格雷联合曲美他嗪治疗冠心病的疗效。方法182例冠心病患者,经随机数字表法分为格雷他嗪组和曲美他嗪组,各91例。曲美他嗪组采用曲美他嗪治疗,格雷他嗪组在曲美他嗪组基础上增加硫酸氢氯吡格雷治疗。比较两组疗效、不良反应发生情况及治疗前后动脉粥样硬化斑块情况、心功能指标、血管内皮功能。结果格雷他嗪组治疗总有效率97.80%显著高于曲美他嗪组的79.12%,差异有统计学意义(P<0.05)。治疗后,格雷他嗪组血管内中膜厚度及颈总动脉粥样硬化斑块体积、直径、厚度分别为(1.63±0.29)mm、(21.39±5.02)mm^(3)、(3.46±1.22)mm、(1.59±0.42)mm,均显著小于曲美他嗪组的(2.04±0.52)mm、(29.56±4.63)mm^(3)、(4.58±0.93)mm、(2.16±0.43)mm,差异有统计学意义(P<0.05)。治疗后,格雷他嗪组左心室舒张末期内径(45.95±8.02)mm、左心室收缩末期内径(38.25±7.02)mm小于曲美他嗪组的(51.97±7.56)、(44.31±8.23)mm,左心室射血分数(54.01±6.38)%高于曲美他嗪组的(47.11±6.23)%,差异有统计学意义(P<0.05)。格雷他嗪组治疗后血管性血友病因子(vWF)(67.59±7.02)%、血清内皮素(ET)(55.63±8.56)ng/L显著低于曲美他嗪组的(81.23±8.69)%、(67.22±7.89)ng/L,一氧化氮(NO)(87.25±5.98)μmol/L显著高于曲美他嗪组的(70.25±6.23)μmol/L,差异有统计学意义(P<0.05)。格雷他嗪组不良反应发生率为10.99%,与曲美他嗪组的8.79%比较,差异无统计学意义(P>0.05)。结论在曲美他嗪抗心绞痛治疗基础上联合应用硫酸氢氯吡格雷抗凝治疗,可有效改善冠心病患者动脉粥样硬化斑块状态和心功能,有助于纠正患者血管内皮功能,可进一步提升患者康复效果,该方案安全性可靠,值得推广借鉴。
Objective To discuss the efficacy of clopidogrel bisulfate combined with trimetazidine in the treatment of coronary heart disease.Methods A total of 182 patients with coronary heart disease were divided into gretazidine group and trimetazine group according to the random numerical table,with 91 cases in each group.Trimetazidine group was treated with trimetazidine,and gretazidine group was treated with clopidogrel bisulfate on the basis of trimetazidine group.The efficacy,occurrence of adverse reactions,atherosclerotic plaque,cardiac function index and vascular endothelial function were compared between the two groups.Results The total effective rate of 97.80%in gretazidine group was significantly higher than that of 79.12%in trimetazidine group,and the difference was statistically significant(P<0.05).After treatment,the intima-media thickness and the volume,diameter and thickness of the common carotid artery atherosclerotic plaque were(1.63±0.29)mm,(21.39±5.02)mm^(3),(3.46±1.22)mm and(1.59±0.42)mm in the gretazidine group,which were significantly lower than those of(2.04±0.52)mm,(29.56±4.63)mm^(3),(4.58±0.93)mm and(2.16±0.43)mm in trimetazidine group,and the differences were statistically significant(P<0.05).After treatment,left ventricular end-diastolic diameter of(45.95±8.02)mm and left ventricular end-systolic diameter of(38.25±7.02)mm in gretazidine group were lower than those of(51.97±7.56)and(44.31±8.23)mm in trimetazidine group;the left ventricular ejection fraction of(54.01±6.38)%in gretazidine group was higher than that of(47.11±6.23)%in trimetazidine group;the differences were statistically significant(P<0.05).After treatment,vWF of(67.59±7.02)%and ET of(55.63±8.56)ng/L in gretazidine group were significantly lower than those of(81.23±8.69)%and(67.22±7.89)ng/L in trimetazidine group;the nitric oxide(NO)of(87.25±5.98)μmol/L in gretazidine group was significantly higher than that of(70.25±6.23)μmol/L in trimetazidine group;the differences were statistically significant(P<0.05).The incidence of adverse reactions in the gretazidine group was 10.99%,which was not statistically significant compared with that of 8.79%in the trimetazidine group(P>0.05).Conclusion The combination of trimetazidine anti-anginal therapy with clopidogrel sulfate anticoagulation therapy can effectively improve the atherosclerotic plaque status and cardiac function in patients with coronary artery disease and help correct the vascular endothelial function of patients,which can further enhance the rehabilitation effect of patients.This protocol is safe and reliable,and is worth promoting.
作者
董效珍
赵积海
余军梅
DONG Xiao-zhen;ZHAO Ji-hai;YU Jun-mei(Second Department of Internal Medicine,Jiayuguan First People's Hospital,Jiayuguan 735100,China)
出处
《中国现代药物应用》
2023年第16期9-13,共5页
Chinese Journal of Modern Drug Application
关键词
硫酸氢氯吡格雷
曲美他嗪
冠心病
疗效
血管内皮功能
Clopidogrel bisulfate
Trimetazidine
Coronary heart disease
Efficacy
Endothelial function
