血必净注射液联合替格瑞洛和阿司匹林治疗急性冠脉综合征的临床研究

目的探讨血必净注射液联合替格瑞洛和阿司匹林治疗急性冠脉综合征(ACS)的临床疗效。方法选取2015年1月—2016年1月在石家庄市第二医院心内科接受治疗的86例ACS患者为研究对象,根据治疗方法的不同分为对照组(43例)和治疗组(43例)。所有患者均给予扩张冠状动脉、降血脂和抗凝血等常规治疗。对照组口服替格瑞洛片,首日剂量180mg/次,1次/d,次日剂量90 mg/次,2次/d;同时口服阿司匹林肠溶片,首日剂量300 mg/次,次日剂量150 mg/次,均为1次/d。治疗组在对照组基础上静脉滴注血必净注射液,50 m L加入生理盐水250 m L,2次/d。两组患者均治疗14 d。观察两组的临床疗效,比较两组治疗前后血清炎性因子、血小板凝集率(PAR)和心功能指标的变化情况以及心血管不良事件发生率。结果治疗后对照组总有效率为81.40%,显著低于治疗组的95.35%,两组总有效率比较差异具有统计学意义(P0.05)。治疗后两组患者血清超敏C-反应蛋白(hs-CRP)、白细胞介素-17(IL-17)、IL-6和基质金属蛋白酶-9(MMP-9)较治疗前均显著降低(P0.05),且治疗组这些血清炎性因子的降低程度优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后两组患者PAR低于治疗前(P0.05),且治疗组降低的更明显(P0.05)。治疗后两组患者的舒张早期二尖瓣血流速度与舒张晚期二尖瓣血流速度比值(E/A)、左心室舒张末期内径(LVEDD)和左心射血分数(LVEF)水平较治疗前均显著升高(P0.05),且治疗组这些心功能指标的改善程度优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后对照组和治疗组的不良反应发生率分别为30.23%和16.28%,两组比较差异具有统计学意义(P0.05)。结论血必净注射液联合替格瑞洛和阿司匹林治疗ACS疗效显著,可明显降低血小板聚集率和炎症反应,改善心功能。

Clinical study on Xuebijing Injection combined with ticagrelor and aspirin in treatment of acute coronary syndrome

Objective To evaluate the clinical efficacies of Xuebijing Injection combined with ticagrelor and aspirin in treatment of acute coronary syndrome (ACS). Methods Patients (86 cases) with ACS in the Department of Cardiology of Shijiazhuang Second Hospital from January 2015 to January 2016 were enrolled in this study. According to the different treatments, they were divided into treatment group (43 cases) and control group (43 cases). All patients were given conventional treatment with coronary artery dilatation, lipid lowering, and anti-coagulation, etc. The patients in the control group were po administered with Ticagrelor Tablets, the first dosage was 180 mg, once daily, and the dosage for the next day was 180 mg/time, twice daily. And they were po administered with Aspirin Enteric-coated Tablets, the first dosage was 300 mg/time, and the second dosage was 150 mg/time, once daily. The patients in the treatment group were iv administered with Xuebijing Injection on the basis of the control group, 50 mL added into normal saline 250 mL, twice daily. The patients in two groups were treated for 14 d. After treatment, clinical efficacies were evaluated. And serum inflammatory factors, PAR, cardiac function index and incidence of cardiovascular adverse events in two groups were compared. Results After treatment, clinical efficacy in the control groups was 81.40%, which was significantly lower than that (95.35%) in the treatment group, and there were significant differences between two groups (P<0.05). After treatment, hs-CRP, IL-17, IL-6 and MMP-9 in two groups were obviously decreased (P<0.05), the changes of serum inflammatory factors in the treatment group were better than those in the control group, with significant difference between two groups (P<0.05). After treatment, PAR in two groups was significantly decreased (P<0.05), and the treatment group had a more obvious decrease (P<0.05). After treatment, E/A, LVEDD and LVEF in the two groups were significantly increased (P<0.05), and these cardiac function indexes in the treatment group were better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the incidences of cardiovascular adverse events in the control and treatment groups were 30.23% and 16.28%, respectively, and the difference was statistically significant between two groups (P<0.05). Conclusion Xuebijing Injection combined with ticagrelor and aspirin in treatment of ACS has a good clinical efficacy, can significantly decrease PAR and inflammatory reaction, and improve the cardiac function.