对行PCI患者应用尼可地尔联合氯吡格雷或替格瑞洛的临床效果对比  

Comparison of clinical effects of nicorandil combined with clopidogrel or ticagrelor in patients undergoing PCI

作　　者：王小波 WANG Xiao-bo(Pharmacy Department,Chengwu County People's Hospital,Heze 274200,China)

机构地区：[1]成武县人民医院药剂科,274200

出　　处：《中国实用医药》2024年第15期6-10,共5页China Practical Medicine

摘　　要：目的探究行经皮冠状动脉介入治疗(PCI)患者联合使用尼可地尔与氯吡格雷或替格瑞洛治疗的临床效果。方法从行PCI治疗的患者中随机抽取100例,并以抽签法分为氯吡格雷组与替格瑞洛组,各50例。两组患者均给予尼可地尔治疗,在此基础上,氯吡格雷组使用氯吡格雷治疗,替格瑞洛组使用替格瑞洛治疗。对比两组患者心功能指标[左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)以及左心室射血分数(LVEF)]、心血管不良事件发生率、TIMI血流分级以及炎性细胞因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)以及C反应蛋白(CRP)]水平。结果术后1周,两组患者LVEDD、LVESD、LVEF均有改善,且替格瑞洛组患者LVEDD(46.14±4.05)mm与LVESD(30.01±3.07)mm均低于氯吡格雷组的(52.03±3.37)、(35.66±3.25)mm,而LVEF(59.38±4.37)%比氯吡格雷组的(50.75±4.06)%更高,组间有统计学差异(P<0.05)。替格瑞洛组心血管不良事件发生率4.00%低于氯吡格雷组的16.00%,组间有统计学差异(P<0.05)。术后1周,替格瑞洛组患者TNF-α、CRP、IL-6水平分别为(3.32±0.66)ng/ml、(3.44±0.87)mg/L、(2.04±0.66)ng/L,显著低于氯吡格雷组的(4.01±0.81)ng/ml、(4.22±1.63)mg/L、(3.05±0.83)ng/L,组间有统计学差异(P<0.05)。替格瑞洛组患者血流分级明显优于氯吡格雷组,组间有统计学差异(Z=3.313,P=0.001<0.05)。结论在尼可地尔基础上使用替格瑞洛或者氯吡格雷均有显著效果,可改善PCI手术患者心功能并预防心血管不良事件发生,但替格瑞洛对患者心功能指标改善更佳,可减轻患者炎性反应,且使用安全性较高,更有利于患者预后效果提升。Objective To explore the clinical effect of nicorandil combined with clopidogrel or ticagrelor in patients undergoing percutaneous coronary intervention(PCI).Methods 100 patients undergoing PCI were randomly selected and divided into clopidogrel group and ticagrelor group using a lot drawing method,with 50 patients in each group.Both groups of patients were treated with nicorandil,and on this basis,the clopidogrel group was treated with clopidogrel,and the ticagrelor group was treated with ticagrelor.Patients in both groups were compared in terms of cardiac function indicators[left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),and left ventricular ejection fraction(LVEF)],incidence of cardiovascular adverse events,and TIMI blood flow grading and inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and C-reactive protein(CRP)]levels.Results 1 week after surgery,LVEDD,LVESD and LVEF were improved in both groups;ticagrelor group had LVEDD of(46.14±4.05)mm and LVESD of(30.01±3.07)mm,which were lower than(52.03±3.37)and(35.66±3.25)mm in clopidogrel group;LVEF was(59.38±4.37)%in ticagrelor group,which was higher than(50.75±4.06)%in clopidogrel group;there was statistical difference between the two groups(P<0.05).The incidence of cardiovascular adverse events in ticagrelor group was 4.00%,which was lower than 16.00%in clopidogrel group,and there was statistical difference between the two groups(P<0.05).1 week after surgery,the levels of TNF-α,CRP and IL-6 in ticagrelor group were(3.32±0.66)ng/ml,(3.44±0.87)mg/L and(2.04±0.66)ng/L,which were significantly lower than(4.01±0.81)ng/ml,(4.22±1.63)mg/L and(3.05±0.83)ng/L in clopidogrel group,and there was statistical difference between the two groups (P<0.05). The blood flow grading of ticagrelor group was significantly better than that of clopidogrel group, and there was statistical difference between the two groups (Z=3.313, P=0.001<0.05). Conclusion On the basis of nicorandil, the use of ticagrelor

关 键 词：经皮冠状动脉介入治疗 尼可地尔 氯吡格雷 替格瑞洛 炎性因子 

分 类 号：R541.4[医药卫生—心血管疾病]