| 王洪,任保权,谢军.不同剂量吲哚布芬联合替格瑞洛对老年冠心病患者经皮冠状动脉介入术后的影响[J].中国临床保健杂志,2023,26(6):782-786. |
| 不同剂量吲哚布芬联合替格瑞洛对老年冠心病患者经皮冠状动脉介入术后的影响 |
| The effect of different doses of indoprofen combined with tigrel on elderly patients with coronary heart disease after percutaneous coronary intervention |
| 投稿时间：2023-05-22 |
| DOI：10.3969/J.issn.1672-6790.2023.06.015 |
| 中文关键词: 冠心病 经皮冠状动脉介入治疗 手术后并发症 替格瑞洛 血小板聚集抑制剂 老年人 |
| 英文关键词: Coronary disease Percutaneous coronary intervention Postoperative complications Ticagrelor Platelet aggregation inhibitors Aged 〖FL |
| 基金项目:河北省秦皇岛市科学技术研究与发展计划项目(202101A032) |
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| 中文摘要: |
| 目的 探讨不同剂量吲哚布芬联合替格瑞洛对老年冠心病患者经皮冠状动脉介入治疗(PCI)术后主要不良心血管事件(MACE)发生情况及血小板功能的影响。方法 选取2019年5月至2022年3月在河北港口集团港口医院接受PCI术的178例老年冠心病患者作为研究对象,采用随机数字表法分为A组(59例)、B组(59例)和C组(60例)。A组在PCI术前给予阿司匹林肠溶片300 mg,替格瑞洛片180 mg负荷,行PCI术后给予阿司匹林肠溶片100 mg/次、1次/d,替格瑞洛片90 mg/次、2次/d。B组在PCI术前给予吲哚布芬片200 mg,替格瑞洛片180 mg负荷,行PCI术后给予吲哚布芬片100 mg/次、2次/d,替格瑞洛片用法同A组。C组吲哚布芬片和替格瑞洛片用法同B组,1个月后给予吲哚布芬片100 mg/次、2次/d,替格瑞洛片60 mg/次、2次/d。术后随访6个月,比较3组术后6个月的临床疗效,治疗前和治疗1个月、治疗3个月后的血小板功能,术后6个月内的MACE事件、不良反应。结果 术后6个月,A组、B组及C组临床有效率分别为89.83%、93.22%、88.33%,3组间差异无统计学意义(P>0.05)。治疗3个月后,3组血小板凝聚率水平及花生四烯酸诱导的最大聚集率、二磷酸腺苷诱导的最大聚集率均低于治疗前、治疗1个月后,治疗1个月后低于治疗前,但3组间比较,差异均无统计学意义(P>0.05)。治疗3个月后,3组血清丙氨酸氨基转移酶、天冬氨酸氨基转移酶、肌酐水平均高于治疗前、治疗1个月后,治疗1个月后高于治疗前,但3组间差异无统计学意义(P>0.05)。术后6个月内,C组的MACE发生率为20.00%,均高于A、B组的15.25%、13.56%,但差异无统计学意义(P>0.05)。术后6个月内,C组的不良反应发生率为1.67%,低于A组的28.81%(P<0.05)。术后6个月内,A、B组轻微出血发生率较C组高(P=0.03)；A、B组呼吸困难发生率较C组高(P=0.01)。结论 吲哚布芬联合替格瑞洛治疗老年冠心病的疗效确切,而减量替格瑞洛治疗安全性较高,不增加MACE事件发生风险。 |
| 英文摘要: |
| Objective To investigate the effect of different doses of indobufen combined with ticagrelor on the occurrence of major adverse cardiovascular events (MACE) and platelet function in elderly patients with coronary heart disease after percutaneous coronary intervention (PCI).Methods A total of 178 elderly patients with coronary heart disease who underwent PCI in Port Hospital,Hebei Port Group from May 2019 to March 2022 were selected as the research subjects,and they were divided into the group A (59 cases),the group B (59 cases) and the group C (60 cases) by random number table method).Group A received 300 mg of aspirin enteric coated tablets and 180 mg of tigregolor tablets before PCI,and 100 mg/time,1 time/d,and 90 mg/time,2 times/d of tigregolor tablets after PCI.Group B received 200 mg of indobufen tablets and 180 mg of tigregolor tablets before PCI,and 100 mg/time,2 times/d of indobufen tablets after PCI.The use of tigregolor tablets was the same as Group A.The usage of indobufen tablets and tigrel tablets in Group C was the same as that in Group B.After 1 month,indobufen tablets were given 100 mg/time,2 times/d,and tigrel tablets were given 60 mg/time,2 times/d.Follow up for 6 months after surgery,compare the clinical efficacy of the three groups at 6 months after surgery,including platelet function before treatment,1 month after treatment,and 3 months after treatment,as well as MACE events and adverse reactions within 6 months after surgery.Results At 6 months after surgery,the clinical effective rates of group A,group B,and group C were 89.83%,93.22%,and 88.33%,respectively.There was no statistically significant difference among the three groups (P>0.05).After 3 months of treatment,the levels of platelet aggregation rate,maximum aggregation rate induced by arachidonic acid,and maximum aggregation rate induced by adenosine diphosphate in the three groups were lower than before treatment and after 1 month of treatment.However,there was no statistically significant difference between the three groups (P>0.05).After 3 months of treatment,the levels of serum alanine aminotransferase,aspartate aminotransferase,and creatinine in the three groups were higher than before and after 1 month of treatment.After 1 month of treatment,the levels were higher than before treatment,but there was no statistically significant difference between the three groups (P>0.05).Within 6 months after surgery,the incidence of MACE in Group C was 20.00%,which was higher than those (15.25% and 13.56%) in the groups A and B,but there was no statistically significant difference (P>0.05).Within 6 months after surgery,the incidence of adverse reactions in the group C was 1.67%,lower than the group A′s 28.81% (P<0.05).Within 6 months after surgery,the incidence of mild bleeding in groups A and B was higher than that in group C (P=0.03);the incidence of dyspnea in the group A and B was higher than that in the group C (P=0.01).Conclusions The combination of indobufen and tigrel in the treatment of elderly coronary heart disease has a definite therapeutic effect,while reduced tigrel treatment is safer and does not increase the risk of MACE events. |
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