吲哚布芬在阿司匹林不耐受老年缺血性心脑血管疾病二级预防中作用及安全性研究  

Efficacy and safety of indolebufen in secondary prevention of ischemic cardiovascular and cerebrovascular diseases in elderly patients with aspirin intolerance

作　　者：刘岩 李斯琪 刘兵 李红帅 徐丽斯 黄带发 刘艳霞 LIU Yan;LI Si-qi;LIU Bing;LI Hong-shuai;XU li-si;HUANG Dai-fa;LIU Yan-xia(The Second Cadre Ward,General Hospital of Northern Theater Command,National Center for Clinical Research of Geriatric Diseases,Shenyang 110016,China)

机构地区：[1]国家老年疾病临床研究中心、北部战区总医院老年医学中心干二科,辽宁沈阳110016

出　　处：《临床军医杂志》2023年第1期36-39,43,共5页Clinical Journal of Medical Officers

基　　金：全军保健专项基金项目(19BJZ14);沈阳市科技计划项目(20-205-4-057)。

摘　　要：目的 探讨吲哚布芬在阿司匹林不耐受的老年缺血性心脑血管疾病二级预防中的作用及安全性。方法 选取北部战区总医院2021年1—9月收治的200例阿司匹林不耐受的老年缺血性心脑血管疾病患者为研究对象。采用随机数字表法将患者分为吲哚布芬组(n=101)与氯吡格雷组(n=99)。吲哚布芬组患者口服吲哚布芬100 mg, 2次/d;氯吡格雷组患者口服氯吡格雷75 mg, 1次/d。分别于用药前,用药后7 d,检测并比较两组患者血小板计数、血红蛋白、活化部分凝血酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT),凝血酶原国际标准化比例(INR)、血浆D-二聚体(D-Dimer)、纤维蛋白原含量(FIB)等指标。检测并比较用药前后吲哚布芬组花生四烯酸(AA)诱导血小板聚集率与氯吡格雷组二磷酸腺苷(ADP)诱导血小板聚集率。随访12个月,记录两组患者用药期间心脑血管不良事件及不良反应发生情况。结果 用药后7 d,吲哚布芬组AA诱导血小板聚集率与氯吡格雷组ADP诱导血小板聚集率均低于用药前,差异均有统计学意义(P<0.05)。吲哚布芬组患者血小板聚集率达标率为97.03%(98/101),高于氯吡格雷组的88.89%(88/99),差异有统计学意义(P<0.05)。吲哚布芬组患者用药后7 d的APTT、PT、TT、INR均高于氯吡格雷组,FIB、D-Dimer均低于氯吡格雷组,差异均有统计学意义(P<0.05)。吲哚布芬组、氯吡格雷组患者心脑血管不良事件发生率分别为4.95%(5/101)、8.08%(8/99),差异无统计学意义(P>0.05)。氯吡格雷组患者不良反应发生率为15.15%(15/99),高于吲哚布芬组的3.96%(4/101),差异有统计学意义(P<0.05)。结论 吲哚布芬可有效抗血小板聚集,在阿司匹林不耐受的老年缺血性心脑血管疾病二级预防中安全性较高。Objective To investigate the effect and safety of indolebufen in secondary prevention of ischemic cardiovascular and cerebrovascular diseases in elderly patients with aspirin intolerance.Methods From January to September 2021,200 elderly patients with ischemic cardiovascular and cerebrovascular diseases with aspirin intolerance admitted to the General Hospital of Northern Theater Command were selected as the research objects.Patients were randomly divided into indolebufen group(n=101)and clopidogrel group(n=99).Indolibuprofen group was given indolibuprofen 100 mg orally, twice a day.Patients in clopidogrel group received clopidogrel 75 mg orally, once daily.Platelet count, hemoglobin, activated partial thrombin time(APTT),prothrombin time(PT)and thrombin time(TT)were detected and compared between the two groups before and 7 days after medication.International standardized ratio of prothrombin(INR),plasma D-dimer(D-Dimer),fibrinogen content(FIB)and other indicators.The platelet aggregation rate induced by arachidonic acid(AA)in indolebufen group and adenosine diphosphate(ADP)in clopidogrel group were detected and compared before and after treatment.The patients were followed up for 12 months, and the incidence of cardiovascular and cerebrovascular adverse events and adverse drug reactions were recorded.Results 7 days after treatment, the platelet aggregation rates induced by AA in indolebufen group and ADP in clopidogrel group were lower than those before treatment, and the differences were statistically significant(P<0.05).The platelet aggregation rate in indolebufen group was 97.03%(98/101),which was higher than 88.89%(88/99)in clopidogrel group, and the difference was statistically significant(P<0.05).The APTT,PT,TT and INR of indolebufen group were higher than those of clopidogrel group, and the FIB and D-Dimer of indolebufen group were lower than those of clopidogrel group at 7 days after treatment, and the differences were statistically significant(P<0.05).The incidence of cardiovascular and cerebrovascular

关 键 词：吲哚布芬 氯吡格雷 缺血性心脑血管疾病 血小板聚集 抗凝 

分 类 号：R541.4[医药卫生—心血管疾病]