银杏达莫注射液联合氯吡格雷治疗急性冠脉综合征的临床研究

目的探讨银杏达莫注射液联合硫酸氢氯吡格雷片治疗急性冠脉综合征的临床疗效。方法选取2016年3月—2017年3月在西安医学院第二附属医院进行治疗的急性冠脉综合征患者78例为研究对象,根据所有患者用药的差别分为对照组和治疗组,每组各39例。对照组口服硫酸氢氯吡格雷片,首次剂量300 mg/次,尔后75 mg/次,1次/d。治疗组在对照组基础上静脉注射银杏达莫注射液,20 m L加入到0.9%氯化钠注射液250 m L中,2次/d。两组均连续治疗14 d。观察两组的临床疗效,比较两组的心电图(ECG)疗效、心功能指标、心绞痛发作次数、心绞痛持续时间和血清学指标。结果治疗后,对照组和治疗组的总有效率和ECG有效率分别均为79.49%、94.87%,两组比较差异有统计学意义(P0.05)。治疗后,两组LVEF和LVEDD显著升高,而LVEDV明显下降,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组心绞痛发作次数和持续时间明显降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血清hs-CRP、MMP-9、ET-1、TN-C水平明显降低,而NO水平明显升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论银杏达莫注射液联合硫酸氢氯吡格雷片治疗急性冠脉综合征具有较好的临床疗效,可改善患者心功能和血管内皮功能,降低机体炎症反应,具有一定的临床推广应用价值。

Clinical study on Ginkgo Leaf Extract and Dipyridamole Injection combined with clopidogrel in treatment of acute coronary syndrome

Objective To investigate the clinical efficacy of Ginkgo Leaf Extract and Dipyridamole Injection combined with Clopidogrel Hydrogen Sulphate Tablets in treatment of acute coronary syndrome. Methods Patients (78 cases) with acute coronary syndrome in the Second Affiliated Hospital of Xi''an Medical College from March 2016 to March 2017 were enrolled in this study. According to the difference treatment plan, patients were divided into control and treatment groups, and each group had 39 cases. Patients in the control group were po administered with Clopidogrel Hydrogen Sulphate Tablets, first dose 300 mg/time, then 75 mg/time, once daily. Patients in the treatment group were iv administered with Ginkgo Leaf Extract and Dipyridamole Injection on the basis of the control group, 20 mL added into normal saline 250 mL, twice daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and ECG efficacies, cardiac function index, frequency and duration of angina pectoris, and serological index in two groups were compared. Results After treatment, the clinical efficacies and ECG efficacies in the control and treatment groups were both 79.49% and 94.87%, respectively, and there was difference between two groups (P<0.05). After treatment, the frequency and duration of angina pectoris in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, LVEF and LVEDD in two groups were significantly increased, but the LVEDV in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of hs-CRP, MMP-9, ET-1, and TN-C in two groups were significantly decreased, but the levels of NO in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Ginkgo Leaf Extract and Dipyridamole Injection combined with clopidogrel has clinical curative effect in treatment of acute coronary syndrome, can improve cardiac function and vascular endothelial function, and reduce inflammatory reaction, which has a certain clinical application value.