胺碘酮联合氯吡格雷治疗心肌梗死的疗效及对患者血清炎症因子及凝血功能的影响  

Efficacy of amiodarone combined with clopidogrel in the treatment of myocardial infarction and its effect on serum inflammatory factors and coagulation function of patients

作　　者：刘亮 李雪梅 韩建伦[1] LIU Liang;LI Xue-mei;HAN Jian-lun(Department of Cardiology,Yulin First Hospital,Yulin 719000,Shaanxi,CHINA)

机构地区：[1]榆林市第一医院心内科,陕西榆林719000

出　　处：《海南医学》2020年第8期976-979,共4页Hainan Medical Journal

摘　　要：目的观察胺碘酮联合氯吡格雷治疗心肌梗死的疗效,并探讨其对患者血清炎症因子、凝血功能的影响。方法选择2017年7月至2018年10月在榆林市第一医院就诊的心肌梗死患者120例作为研究对象,按随机数表法将患者分为观察组和对照组各60例。对照组患者采用氯吡格雷治疗,观察组患者采用胺碘酮联合氯吡格雷治疗,均治疗2周。治疗2周后,比较两组患者的治疗效果、治疗前后的免疫炎症反应和凝血功能状况,以及治疗期间的不良反应发生情况。结果治疗2周后,观察组患者的治疗总有效率为95.00%,明显高于对照组的83.33%,差异有统计学意义(P<0.05);治疗前,两组患者的免疫炎症反应比较差异均无统计学意义(P<0.05);治疗后,两组患者的白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)均明显低于治疗前,且观察组上述各指标明显低于对照组,差异均有统计学意义(P<0.05);治疗前,两组患者的凝血功能比较差异均无统计学意义(P>0.05);治疗后,两组患者凝血酶原时间(TP)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)明显高于治疗前,且观察组患者的上述各项指标明显高于对照组,差异均有统计学意义(P<0.05);观察组患者的不良反应总发生率为6.67%,明显低于对照组的20.00%,差异有统计学意义(P<0.05)。结论胺碘酮联合氯吡格雷治疗心肌梗死疗效确切,可有效抑制血清炎症因子,改善凝血功能,减少不良反应发生率,值得临床进一步推广使用。Objective To investigate the efficacy of amiodarone combined with clopidogrel in the treatment of myocardial infarction and the effect on serum inflammatory factors and coagulation function of patients,and to provide a basis for clinical treatment.Methods A total of 120 patients with myocardial infarction treated in Yulin First Hospital from July 2017 to October 2018 were selected as the study subjects.According to random number table,the patients were assigned to receive clopidogrel(observation group,n=60)or amiodarone and clopidogrel(control group,n=60)for two weeks.After 2 weeks of treatment,the therapeutic effect,the immune inflammatory reaction,and coagulation function before and after treatment,as well as the adverse reactions during treatment were compared between the two groups.Results After 2 weeks of treatment,the total effective rate of the observation group(95.00%)was significantly higher than that of the control group(83.33%),and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in the immune inflammatory response between the two groups of patients(P<0.05).After treatment,interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)were significantly lower than those before treatment,and the above indicators in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the coagulation function between the two groups of patients before treatment(P>0.05);after treatment,the prothrombin time(TP),activated partial thromboplastin time(APTT),and(TT)were significantly higher than those before treatment,and the above indicators in the observation group were significantly higher than those in the control group(P<0.05).The total incidence of adverse reactions in the observation group was 6.67%,which was significantly lower than 20.00%in the control group(P<0.05).Conclusion Amiodarone combined with clopidogrel in the treatment of myocardial infarction can effectively inhibit

关 键 词：急性心肌梗死 胺碘酮 氯吡格雷 白细胞介素-6 肿瘤坏死因子-Α C反应蛋白 

分 类 号：R542.22[医药卫生—心血管疾病]