普伐他汀联合氯吡格雷对急性冠状动脉综合征患者经皮冠状动脉介入术后的影响研究  

Effects of pravastatin combined with clopidogrel in patients with acute coronary syndrome after percutaneous coronary intervention

作　　者：王裕岱[1] 董小莉[1] 李斌[1] WANG Yu-dai;DONG Xiao-li;LI Bin(Department of Cardiology,Hainan General Hospital,Haikou 570311,Hainan Province,China)

机构地区：[1]海南省人民医院心血管内科

出　　处：《中国临床药理学杂志》2019年第22期2779-2781,2789,共4页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察普伐他汀联合氯吡格雷对急性冠状动脉综合征(ACS)患者经皮冠状动脉介入(PCI)治疗术后血管内皮和斑块稳定性的影响。方法将128例PCI术后ACS患者,随机分为试验组64例和对照组64例。对照组患者给予阿司匹林,每次100 mg,每天1次,氯吡格雷,每次75 mg,每天1次。药物治疗由入院1 h开始,持续治疗30 d。试验组患者联用普伐他汀,每次20 mg,每天1次,药物治疗由入院1 h开始,持续治疗30 d。比较2组患者的血小板活化指标、血小板聚集率(MPAR)、内皮功能、心肌酶谱和药物不良反应发生率。结果治疗后,试验组CD62p、CD63p、GPⅡb/Ⅲa受体、血小板聚集率(MPAR)、内皮素-1、谷草转氨酶(GOT)、肌酸激酶(CK)水平分别为5.74±1.43,5.31±1.27,18.61±5.17,(21.14±2.25)%,(59.37±13.49)ng·L^-1,(45.34±12.14)U·L^-1,(65.31±56.24)U·L^-1,对照组分别为9.12±1.57,7.93±2.46,31.14±7.15,(34.13±2.17)%,(86.21±13.42)ng·L^-1,(68.58±12.48)U·L^-1,(95.38±59.61)U·L^-1,差异均有统计学意义(均P<0.05)。治疗后,试验组和对照组一氧化氮(NO)水平分别为(84.12±9.79),(61.27±8.68)μmol·L^-1,差异有统计学意义(P<0.05)。治疗后,试验组患者心血管事件发生率为6.25%(4例/64例),术后再狭窄率为3.13%(2例/64例),对照组分别为17.19%(11例/64例)和14.06%(9例/64例),差异有统计学意义(P<0.05)。结论普伐他汀联合氯吡格雷可有效抑制ACS患者PCI术后血栓的新生及斑块脱落,提高血管内皮功能,减轻患者心肌损伤,改善患者预后。Objective To investigate the effects of pravastatin combined with clopidogrel on vascular endothelium and plaque stability in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods A total of 128 patients with ACS after PCI were randomly divided into treatment group(n=64)and control group(n=64).Patients in control group were given aspirin 100 mg,once a day,and clopidogrel 75 mg,once a day.The drug treatment began within 1 h of admission and lasted for 30 d.Patients in treatment group were treated combined with pravastatin 20 mg,once a day.The drug treatment began within 1 h after admission and lasted for 30 d.The platelet activation index,platelet aggregation rate(MPAR),endothelial function,myocardial enzyme spectrum and incidence of adverse drug reactions were compared between the two groups.Results After treatment,the levels of CD62 p,CD63 p,GPⅡb/Ⅲa receptor,endothelin-1,glutamic-oxaloacetic transaminase(GOT),creatine kinase(CK)and MPAR in treatment group were 5.74±1.43,5.31±1.27,18.61±5.17,(21.14±2.25)%,(59.37±13.49)ng·L^-1,(45.34±12.14)U·L^-1,(65.31±56.24)U·L^-1,all had significant difference with those in control group,which were 9.12±1.57,7.93±2.46,31.14±7.15,(34.13±2.17)%,(86.21±13.42)ng·L^-1,(68.58±12.48)U·L^-1,(95.38±59.61)U·L^-1(all P<0.05).After treatment,the level of nitric oxide(NO)in treatment group and control group were(84.12±9.79),(61.27±8.68)μmol·L^-1,with significant difference(P<0.05).After treatment,the incidences of cardiovascular events and postoperative restenosis in treatment group were 6.25%(4 cases/64 cases)and 3.13%(2 cases/64 cases),had significant difference with those in control group,which were 17.19%(11 cases/64 cases),14.06%(9 cases/64 cases)(P<0.05).Conclusion Pravastatin combined with clopidogrel can effectively inhibit thrombosis and plaque loss after PCI in patients with ACS,improve vascular endothelial function,alleviate myocardial injury and promote prognosis of patients.

关 键 词：经皮冠状动脉介入治疗 急性冠状动脉综合征 普伐他汀 氯吡格雷 心肌酶谱 血小板聚集率 内皮功能 血小板活化指标 

分 类 号：R972[医药卫生—药品]