二丁酰环磷腺苷联合替罗非班治疗急性冠状动脉综合征的临床研究  

Clinical study on dibutyacyladenosine cyclophosphate combined with tirofiban in treatment of acute coronary syndrome

作　　者：骆元正[1] LUO Yuan-zheng(Department of Cardiology,Tianjin Public Security Hospital,Tianjin 300042,China)

机构地区：[1]天津市公安医院心内科,天津300042

出　　处：《现代药物与临床》2018年第11期2795-2799,共5页Drugs & Clinic

摘　　要：目的探讨注射用二丁酰环磷腺苷钙联合盐酸替罗非班注射液治疗急性冠状动脉综合征的临床疗效。方法选取2016年4月—2017年4月天津市公安医院心内科收治的急性冠状动脉综合征患者130例作为研究对象,按照随机数字表法将所有患者分为对照组和治疗组,每组各65例。对照组患者静脉滴注盐酸替罗非班注射液,0.4μg/(kg·min),给药30 min,维持剂量按照0.1μg/(kg·min),使用2～5 d。治疗组在对照组治疗的基础上静滴注射用二丁酰环磷腺苷钙,40 mg加入到5%葡萄糖注射液250m L中,1次/d。14d为1个疗程,两组患者均连续治疗4周。观察两组患者的临床疗效,同时比较治疗前后两组的心功能指标、炎症因子水平和不良事件发生情况。结果治疗后,对照组和治疗组的总有效率分别为81.5%、95.4%,两组比较差异具有统计学意义(P<0.05)。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)、左房舒张末期内径(LADD)和左室射血分数(LVEF)水平均显著升高,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组的心功能指标显著高于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶-9(MMP-9)和同型半胱氨酸(Hcy)水平均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组的炎症因子水平均显著低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,对照组和治疗组的不良事件发生率分别为10.8%、27.7%,两组比较差异具有统计学意义(P<0.05)。结论注射用二丁酰环磷腺苷钙联合盐酸替罗非班注射液治疗急性冠状动脉综合征具有较好的临床疗效,能显著改善患者心功能和炎症因子水平,减少心血管不良事件的发生,具有一定的临床推广应用价值。Objective To investigate the clinical efficacy of Calcium Dibutyacyladenosine Cyclophosphate for injection combined with Tirofiban hydrochloride Sodium Chloride Injection in treatment of acute coronary syndrome. Methods Patients（130 cases） with acute coronary syndrome in Tianjin Public Security Hospital from April 2016 to April 2017 were randomly divided into control and treatment groups, and each group had 65 cases. Patients in the control group were iv administered with Tirofiban hydrochloride Sodium Chloride Injection, 0.4 μg/（kg·min） administered for 30 min, the maintenance dose of 0.1 μg/（kg·min） was used for 2 — 5 d. Patients in the treatment group were iv administered with Calcium Dibutyacyladenosine Cyclophosphate for injection on the basis of the control group, 40 mg was added to 5% glucose injection 250 mL, once daily. A course of treatment had 14 d, and patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the cardiac function indexes, inflammatory factors levels, and adverse event in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 81.5% and 95.4%, and there were differences between two groups（P〈0.05）. After treatment, the LVEDD, LVESD, LADD and LVEF levels in two groups were significantly increased, and the difference was statistically significant in the same group（P〈0.05）. After treatment, the cardiac function indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups（P〈0.05）. After treatment, the TNF-α, MMP-9, and Hcy levels in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. After treatment, the inflammatory factors levels in the treatment group were significantly lower than those in the control group, with significant difference between two groups（P〈0.05）. Afte

关 键 词：注射用二丁酰环磷腺苷钙 盐酸替罗非班注射液 急性冠状动脉综合征 心功能指标 炎症因子 肿瘤坏死因子-Α 基质金属蛋白酶-9 同型半胱氨酸 不良事件 

分 类 号：R972[医药卫生—药品]