丹参多酚酸盐联合替格瑞洛治疗急性冠状动脉综合征的临床研究

目的观察丹参多酚酸盐联合替格瑞洛治疗急性冠状动脉综合症的临床疗效。方法选取郑州市骨科医院心内科2016年10月—2017年9月收治的急性冠状动脉综合征患者106例,随机分为对照组和治疗组,每组各53例。对照组口服替格瑞洛片,首剂量180 mg/次,然后90 mg/次,2次/d;治疗组在对照组基础上静脉滴注注射用丹参多酚酸盐,200 mg加入5%葡萄糖注射液,1次/d。两组患者均治疗3周。评价两组患者临床疗效,同时比较治疗前后两组患者心电图改善情况、临床症状改善、心功能指标、炎症情况、心功能和血小板功能。结果治疗后,对照组临床有效率和心电图有效率分别为73.58%和66.04%,均分别显著低于治疗组的92.45%和86.79%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者心绞痛发作次数和持续时间均显著减少(P0.05);且治疗组心绞痛临床症状明显优于对照组(P0.05)。治疗后,两组患者左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)和左室射血分数(LVEF)显著升高(P0.05);且治疗组上述心功能指标明显高于对照组明显(P0.05)。治疗后,两组患者超敏C反应蛋白(hs-CRP)、N末端B型钠尿肽原(NT-pro BNP)和血小板聚集率(MPA)水平显著降低(P0.05),血小板反应指数(PRI)显著升高(P0.05);且治疗组这些指标明显优于对照组(P0.05)。结论丹参多酚酸盐联合替格瑞洛治疗冠状动脉综合症可有效改善患者炎性反应和心脏功能,不良反应较少,具有一定的临床推广应用价值。

Clinical study on salvianolate combined with ticagrelor in treatment of acute coronary syndrome

Objective To observe the clinical efficacy of salvianolate combined with ticagrelor in treatment of acute coronary syndrome. Methods Patients (106 cases) with acute coronary syndrome in Zhengzhou Orthopedics Hospital from October 2016 to September 2017 were randomly divided into control and treatment group, and each group had 53 cases. Patients in the control group were po administered with Ticagrelor Tablets, the first dose was 180 mg/time, then 90 mg/time, twice daily. Patients in the treatment group were iv administered with Salvianolate for injection on the basis of the control group, 200 mg added into 5% glucose injection, once daily. Patients in two groups were treated for 3 weeks. After treatment, the clinical efficacies were evaluated, and the improvement of ECG and clinical symptoms, the cardiac function indexes, the inflammation, heart function and platelet function in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and electrocardiogram efficiency in the control group were 73.58% and 66.04%, which were significantly lower than 92.45% and 86.79% in the treatment group, respectively, and there were differences between two groups (P<0.05). After treatment, the frequency and duration of angina pectoris in two groups was significantly decreased (P<0.05), and the clinical symptoms of angina pectoris in the treatment group after treatment was significantly better than that in the control group (P<0.05). After treatment, the LVEDD, LVESD and LVEF in two groups was significantly increased (P<0.05), and the cardiac function indexes in the treatment group after treatment were significantly higher than those in the control group (P<0.05). After treatment, the hs-CRP, NT-proBNP and MPA in two groups was significantly decreased (P<0.05), but PRI was significantly increased (P<0.05). And these indexes in the treatment group after treatment were significantly better than those in the control group (P<0.05). Conclusion Salvianolate combined with ticagrelor in treatment of acute coronary syndrome can effectively improve the inflammatory reaction and cardiac function with less adverse reactions, which has a certain clinical application value.