吲哚布芬联合氯吡格雷预防冠状动脉旁路移植术后大隐静脉桥血管再狭窄的临床疗效及安全性  

Clinical Efficacy and Safety of Indobufen Combined with Clopidogrel in Preventing Vascular Restenosis in Saphenous Vein Grafts Following Coronary Artery Bypass Grafting

作　　者：周朝元[1] 苏国宝[1] 刘晓晨[1] 李保春 刘辉[1] ZHOU Chao-yuan;SU Guo-bao;LIU Xiaochen;LI Bao-chun;LIU Hui(Cardiovascular Surgery,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,China)

机构地区：[1]新乡医学院第一附属医院心血管外科,新乡453100

出　　处：《中国合理用药探索》2023年第5期122-126,共5页Chinese Journal of Rational Drug Use

基　　金：河南省医学科技攻关计划项目(201602155)。

摘　　要：目的:探讨吲哚布芬联合氯吡格雷预防冠状动脉旁路移植术(CABG)后大隐静脉桥血管再狭窄的临床疗效及安全性。方法:回顾性分析2019年1月~2020年12月某院收治的接受CABG术患者84例作为研究对象,根据术后接受抗血小板药物方案分为A组(n=34)和B组(n=50),A组患者术后给予吲哚布芬联合氯吡格雷治疗,B组给予阿司匹林联合氯吡格雷治疗。对患者展开为期1年的随访,对比两组患者随访期间大隐静脉桥血管再狭窄率、不良心血管事件和不良反应发生情况;对比两组患者手术前和随访结束时凝血功能指标。结果:A组患者大隐静脉桥血管再狭窄率(5.89%)与B组(8.00%)相比无统计学差异(P>0.05);随访期间,A组患者不良心血管事件发生率(2.94%)与B组(6.00%)相比无统计学差异(P>0.05);A组患者不良事件发生率(5.89%)低于B组(22.00%,P<0.05);两组患者术后1年纤维蛋白原(FIB)、D-二聚体(D-dimer)均降低,而血小板计数(PLT)升高(P<0.05)。结论:相较于阿司匹林,吲哚布芬联合氯吡格雷预防CABG术后大隐静脉桥血管再狭窄的临床疗效更好且安全性较高。Objective:To investigate the clinical efficacy and safety of indobufen combined with clopidogrel in the prevention of vascular restenosis in saphenous vein grafts following coronary artery bypass grafting(CABG).Methods:Eighty-four patients undergoing CABG during January 2019 to December 2020 were retrospectively analyzed.They were assigned into group A(n=34)and group B(n=50)according to the antiplatelet drug regimen used after CABG.Patients in group A were treated with indobufin combined with clopidogrel,while patients in group B were treated with aspirin combined with clopidogrel.The patients were followed up for 1 year for evaluation of the restenosis rate in saphenous vein grafts,cardiovascular adverse events and adverse reactions between the two groups.Coagulation function parameters before surgery and at the end of follow-up were compared between the two groups.Results:There was no statistically significant difference in vascular restenosis rate between Group A(5.89%)and Group B(8.00%,P>0.05).During the follow-up period,the incidence of cardiovascular adverse events was 2.94%in group A and 6.00%in group B,with no statistical difference(P>0.05).The incidence of adverse events in group A(5.89%)was lower than that in group B(22.00%,P<0.05).Fibrinogen(FIB)and D-dimer were decreased,while platelet count(PLT)was increased in both groups(P<0.05),at one year post-surgery.Conclusion:Compared with aspirin combined with clopidogrel,indobufen combined with clopidogrel has better clinical efficacy and safety profile in the prevention of vascular restenosis in saphenous vein grafts after CABG.

关 键 词：吲哚布芬 氯吡格雷 冠状动脉旁路移植术 临床疗效 安全性 

分 类 号：R543.3[医药卫生—心血管疾病]