氯吡格雷联合依那普利对心肌梗死患者动脉粥样硬化病变消退程度的影响  

Effect of clopidogrel and enalapril on regression of atherosclerotic lesions in patients with myocardial infarction

作　　者：张宏剑 翁志远[1] 黄亚辉[1] 姜军[1] 张奇[1] 程林 Zhang Hongjian;Weng Zhiyuan;Huang Yahui;Jiang Jun;Zhang Qi;Cheng Lin(First Department of Cardiology,Jiamusi Central Hospital,Jiamusi 154002,China)

机构地区：[1]佳木斯市中心医院心内一科,154002

出　　处：《国际医药卫生导报》2019年第21期3563-3566,共4页International Medicine and Health Guidance News

摘　　要：目的探究心肌梗死采取氯吡格雷联合依那普利治疗对患者动脉粥样硬化病变消退程度的影响.方法人选病例选取本院收治的90例心肌梗死患者,收治时间为2017年1月至2018年9月期间,按随机数表法分成对照组(45例)与观察组(45例),对照组单纯使用氯吡格雷,观察组在此基础上使用依那普利,比较两组治疗前后血清指标变化[血高同型半胱氨酸(Hcy)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CLRP)]、动脉粥样硬化病变程度[颈动脉内膜中层厚度(IMT)、99Tcm-MIBI摄取分数]、心脏不良事件发生率.结果相比对照组,观察组患者治疗后Hcy、TNF-α、CRP均较低,差异均有统计学意义(均P<0.05);相比对照组,观察组治疗后IMT较低,99Tcm-MIBI摄取分数较高,差异均有统计学意义(均P<0.05);相比对照组,观察组心脏不良事件发生率较低(4.44%比17.78%),差异有统计学意义(P<0.05).结论心肌梗死患者采取氯吡格雷联合依那普利治疗可降低Hcy水平,改善动脉粥样硬化程度,减少心脏不良事件发生.Objective To investigate the effect of clopidogrel and enalapril on the regression of atherosclerotic lesions in patients with myocardial infarction.Methods 90 patients with myocardial infarction treated in our hospital from January,2017 to September,2018 were selected.The patients were divided into a control group(45 cases)and an observation group(45 cases)according to random number table method.The control group was treated with clopidogrel,and the observation group with clopidogrel and enalapril.The serum levels of C reactive protein(CRP),homocysteine(Hcy),and tumor necrosis factor-α(TNF-α),degree of atherosclerosis[carotid intima-media thickness(IMT),99Tcm-MIBI uptake fraction],and incidence of cardiac adverse events before and after treatment were compare between the two groups.Results After the treatment,the levels of Hcy,TNF-α,and CRP,as well as IMT and the incidence of cardiac adverse events,were lower and the 99Tcm-MIBI uptake score was higher in the observation group than in the control group(all P<005).Conclusion Clopidogrel combined with enalapril can reduce the level of Hcy and the occurrence of cardiac adverse events and improve atherosclerosis in patients with myocardial infarction.

关 键 词：心肌梗死 氯吡格雷 依那普利 动脉粥样硬化 

分 类 号：R54[医药卫生—心血管疾病]