氯吡格雷治疗非ST段抬高急性冠状动脉综合征及对N端前体脑钠肽的影响  

Effects of clopidogrel on NSTE -acute coronary syndrome and plasma N-terminal proB-type natriuretic peptide

作　　者：张云[1] 孙一荣[1] 辛峰[1] 董爱芝[1] 

机构地区：[1]山东省聊城市第二人民医院,山东省临清市252601

出　　处：《实用医学杂志》2009年第16期2739-2741,共3页The Journal of Practical Medicine

摘　　要：目的:探讨氯吡格雷治疗非ST段抬高急性冠状动脉综合征(NSTE-ACS)及对N端前体脑钠肽(NT-proBNP)的影响。方法:选择NSTE-ACS患者80例,入选患者随机单盲分为氯吡格雷组(治疗组)40例,常规治疗组(常规组)40例,选择稳定型心绞痛患者(SAP组)40例,测定入院时和治疗8周后血浆NT-proBNP水平,并与40例正常健康人(对照组)作对照。结果:NSTE-ACS患者血浆NT-proBNP水平明显高于SAP组和对照组(P<0.05);SAP组和对照组比较,无统计学意义(P>0.05);NSTE-ACS患者经过治疗后血浆NT-proBNP水平低于治疗前(P<0.05),治疗组下降更明显(P<0.05)。结论:NSTE-ACS患者血浆NT-proBNP水平明显升高,是NSTE-ACS患者预后的预测因子,氯吡格雷能明显降低NSTE-ACS患者血浆NT-proBNP水平,为氯吡格雷在NSTE-ACS患者中的应用提供了临床依据。Objective To evaluate the effects of clopidogrel on NSTE -acute coronary syndrome and plasma N- terminal proB-type uatriuretic peptide. Methods A total of 80 patients with NSTE-acute coronary syndrome （NSTE- ACS） were single-blinded randomly separated into two groups： clopidogrel treatment groups （n = 40） and routine therapy group （n = 40）. The treatment group received （300 mg loading dose clopidogrel and followed by 75 mg daily thereafter） ,while the routine therapy group received routine therapy. By using ELISA, the plasma concentrations of NT- proBNP both in patients with NSTE-ACS, and in 40 adults with stable angina （SAP group）, were detected at the admission to the hospital and at 8 weeks after treatment. These are then compared to 40 healthy adults（control group）. Results The plasma NT-proBNP concentration of NSTE-ACS patients was significantly higher than that in patients with stable angina （SAP）and control group （P 〈 0.05）. There were no significant differences in plasma NT-proBNP concentration of SAP group and control group （P 〉 0.05）. After 8-week therapy, the levels of plasma NT-proBNP in NSTE-ACS patients decreased significantly （P 〈 0.05）, so as in the clopidogrel group （P 〈 0.05）. Conclusion The plasma NT-proBNP concentration significantly increases in NSTE-ACS, which is a good indicator for prognosis in patients with NSTE acute coronary syndrome. Clopidogrel could decrease the plasma concentration of NT-proBNP, which may provide a clinical evidence of using clopidogrel in NSTE-ACS patients.

关 键 词：冠状动脉疾病 氯吡格雷 N端前体脑钠肽 

分 类 号：R541.4[医药卫生—心血管疾病]