塞来昔布治疗急性冠状动脉综合征的疗效观察  

Clinical Efficacy of Celecoxib on Acute Coronary Syndrome

作　　者：林锋[1] 丁世芳[1] 蒋桔泉[1] 卢青[1] 

机构地区：[1]广州军区武汉总医院心血管内科,湖北武汉430070

出　　处：《华南国防医学杂志》2013年第1期39-41,63,共4页Military Medical Journal of South China

摘　　要：目的探讨塞来昔布治疗急性冠脉综合征(acute coronary syndrome,ACS)的疗效及其对患者血清超敏C-反应蛋白(high sensitivity C-reactive protein,hs-CRP)水平的影响。方法 155例ACS患者随机分为实验组和对照组,其中对照组77例,实验组78例。两组患者均给予抗血小板、抗凝、抗缺血、抗心力衰竭及抗心律失常等治疗,实验组在上述治疗基础上,加用塞来昔布(200 mg,2/d;2周后改为200 mg,1/d,长期服用)。服药前、服药后1周、2周、1月、3月和6月测定血清hs-CRP水平。所有患者均随访6个月,比较两组患者心血管事件和不良反应发生情况。结果两组患者治疗后血清hs-CRP水平均较治疗前显著下降(P<0.05),而且实验组患者血清hs-CRP水平显著低于对照组(P<0.05)。治疗后1周,对照组症状缓解率为93.5%(72/77),实验组为96.2%(75/78),两组之间无统计学差异(P>0.05);出院后随访6个月,对照组再次住院率为42.9%(32/77)、心力衰竭发生率为38.8%(26/77)、心肌梗死发生率为18.2%(14/77),实验组分别为26.5%(18/78)、16.2%(11/78)和6.5%(5/78),实验组均明显低于对照组(P<0.05)。对照组全因死亡率为7.8%(6/77),实验组为5.9%(4/78),两组之间无统计学差异(P>0.05)。两组均未发生严重副反应。结论常规治疗基础上加用塞来昔布治疗ACS可显著降低减少严重心血管事件的发生率,且无严重的不良反应,安全有效。Objective To evaluate the clinical efficacy of celecoxib on acute coronary syndrome （ACS） and its effect on the serum level of high-sensitivity C-reactive protein （hs-CRP） in patients with ACS. Methods A total of 155 patients with ACS were randomly divided into experimental group （n = 78） and control group （n = 77）. The control group accept-ed conventional treatment, and the experimental group was additionally treated by eelecoxib （200 mg, twice a day for 2 weeks; then 200 mg, once a day for 6 months）. Before treatment and one week, two weeks, one month, three months and six months after treatment, the serum hs-CRP levels were tested. All patients were followed up for 6 months. The incidence of cardiovascular events and bad reaction was recorded and compared. Results The serum levels of hs-CRP were significantly lower than that before treatment both in control group and experimental group （P〈0. 05）, and significantly lower in experimental group than in control group （P〈0. 05）. There was no difference in curative rate between experi-mental group （98. 0% , 76/78） and control group （98.7%, 76/77; P〉0. 05） one week after treatment. The rates of re-hospitalization, heart failure, and myocardial infarction were 42. 9% （32/77）, 38. 8% （26/77） and 18.2% （14/77） in control group respectively. They were 26. 50/00 （18/78）, 16. 2% （11/78）, 6. 5%（5/78） in experimental group respective-ly, all significantly lower than those in control group （P〈0. 05）. There was no difference in the mortality rate between control group （7. 8%, 6/77） and experimental group （5.9%, 4/78; P〉0. 05）. Conclusion Celecoxib can significantly decrease serum level of hs-CRP and reduce the incidence of serious cardiovascular events in patients with ACS.

关 键 词：急性冠脉综合征 塞来昔布 疗效 

分 类 号：R543.3[医药卫生—心血管疾病]