尼可地尔联合氯吡格雷对急性冠脉综合征患者PCI术后血小板活化指标及血清BNP、MMP-9的影响  

Effects of Nicorandil Combined with Clopidogrel on Platelet Activation Indicators and Serum BNP and MMP-9 in Patients with Acute Coronary Syndrome After Percutaneous Coronary Intervention

作　　者：蔡今伦 王立中 贾耀文 张建秀[1] CAI Jinlun;WANG Lizhong;JIA Yaowen;ZHANG Jianxiu(Cardiac Rehabilitation Center,Beijing Rehabilitation Hospital,Capital Medical University,Beijing 100043,China)

机构地区：[1]首都医科大学附属北京康复医院心脏康复中心,北京100043

出　　处：《中国医院用药评价与分析》2022年第9期1105-1108,共4页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:探讨尼可地尔联合氯吡格雷对急性冠脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后血小板活化指标及血清脑钠肽(BNP)、基质金属蛋白酶9(MMP-9)的影响。方法:选取2020年8月至2021年10月于该院接受PCI治疗的63例ACS患者作为研究对象,采用随机数字表法分为对照组31例和观察组32例。对照组患者术前采用常规氯吡格雷治疗方案,观察组患者在对照组基础上联合尼可地尔治疗。比较两组患者术前及术后24 h时的血小板活化指标[CD62p、CD63p和血小板聚集率(PAR)]、血流动力学指标[收缩期血流速度峰值(PSV)、血浆黏度(PV)和全血黏度(BV)]、血清学指标[BNP、MMP-9和肌酸激酶同工酶(CK-MB)]和心功能指标[左心室舒张末期内径(LVEDD)、左心室收缩末期内经(LVESD)和左心室射血分数(LVEF)]水平。结果:术后24 h时,两组患者CD62p、CD63p、PAR、PV、BV、BNP、MMP-9、LVEDD和LVESD水平均显著低于术前,且观察组患者上述指标水平显著低于对照组,差异均有统计学意义(P<0.05)。术后24 h时,两组患者PSV、CK-MB和LVEF水平均显著高于术前;观察组患者PSV、LVEF水平显著高于对照组,但CK-MB水平显著低于对照组,上述差异均有统计学意义(P<0.05)。结论:尼可地尔联合氯吡格雷可有效抑制ACS患者PCI术后血小板活化情况,促进机体血流动力学改善,同时可有效减轻心肌损伤,改善患者术后心功能,临床应用价值显著。OBJECTIVE:To probe into the effects of nicorandil combined with clopidogrel on platelet activation indicators and serum brain natriuretic peptide(BNP)and matrix metalloproteinase 9(MMP-9)in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).METHODS:A total of 63 patients with ACS who received PCI in the hospital from Aug.2020 to Oct.2021 were extracted to be divided into the control group(n=31)and the observation group(n=32)via the random number table method.The control group was treated with conventional clopidogrel before surgery,and the observation group additionally received nicorandil on the basis of the control group.The platelet activation indicators[CD62p,CD63p,platelet aggregation rate(PAR)],hemodynamic indicators[peak systolic velocit(PSV),plasma viscosity(PV),whole blood viscosity(BV)],serological indicators[BNP,MMP-9,creatine phosphokinase(CK-MB)]and cardiac function indicators[left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left ventricular ejection fraction(LVEF)]before surgery and after surgery of 24 h were compared between two groups.RESULTS:After surgery of 24 h,the levels of CD62p,CD63p,PAR,PV,BV,BNP,MMP-9,LVEDD and LVESD in two groups were significantly lower than those before surgery,and the above indicators in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05).After surgery of 24 h,the levels of PSV,CK-MB and LVEF in two groups were significantly higher than those before surgery,and the levels of PSV and LVEF in the observation group were significantly higher than those in the control group,while the level of CK-MB was significantly lower than that in the control group,with statistically significant differences(P<0.05).CONCLUSIONS:Nicorandil combined with clopidogrel can effectively inhibit platelet activation in patients with ACS after PCI,promote the improvement of hemodynamics,reduce the myocardial injury and improve the postoperat

关 键 词：急性冠脉综合征 经皮冠状动脉介入治疗 氯吡格雷 尼可地尔 血小板活化 心肌损伤 

分 类 号：R972[医药卫生—药品]