吲哚布芬联合尼可地尔对高出血风险不稳定型心绞痛的疗效及安全性分析  

Efficacy and safety of indobufen combined with nicorandil in treatment of unstable angina with high bleeding risk

作　　者：王蕾[1] 董少元 原文龙 郝六一[1] 李永慧[1] 屈艳玲 Wang Lei;Dong Shao-yuan;Yuan Wen-long;Hao Liu-yi;Li Yong-hui;Qu Yan-ling(Department of Cardiology,Yuncheng Central Hospital Affiliated to Shanxi Medical University,Yuncheng 044000,China)

机构地区：[1]山西医科大学附属运城市中心医院心血管内科,运城044000

出　　处：《中国药物应用与监测》2024年第6期691-694,共4页Chinese Journal of Drug Application and Monitoring

摘　　要：目的探讨吲哚布芬联合尼可地尔对高出血风险的不稳定型心绞痛(UAP)的疗效及安全性。方法回顾性分析2023年1月至2024年4月山西省运城市中心医院收治的82例高出血风险UAP患者的病历资料,根据不同治疗方法分为对照组(n=41)和联合组(n=41)。所有患者给予常规治疗,对照组予以阿司匹林片口服,联合组予以吲哚布芬片联合尼可地尔片。比较两组临床疗效、纤维蛋白原(FIB)含量、血小板聚集率(PAG)、血管内皮损伤指标,记录出血事件发生情况。结果治疗后,联合组总有效率95.12%(39/41)高于对照组78.05%(32/41)(χ^(2)=5.145,P<0.05)。治疗后,两组FIB、PAG以及血清同型半胱氨酸水平均较治疗前降低,且联合组[分别为(2.53±0.46)g·L^(-1),(31.75±4.08)%,(18.12±3.81)mmol·L^(-1)]均低于对照组[分别为(3.47±0.69)g·L^(-1),(36.24±4.83)%,(20.56±4.25)mmol·L^(-1)](t=7.258,4.547,2.737,均P<0.05);治疗后,两组血清一氧化氮水平均较治疗前升高,且联合组[(141.26±14.38)μmol·L^(-1)]高于对照组[(103.48±11.67)μmol·L^(-1)](t=13.062,P<0.05)。两组出血事件发生率比较差异无统计学意义(2.44%,1/41 vs 9.76%,4/41)(χ^(2)=1.917,P>0.05)。结论吲哚布芬联合尼可地尔对于高出血风险的不稳定型心绞痛具有更好的临床疗效,有效改善患者凝血功能与血管损伤,未增加出血事件的发生率。Objective To explore the efficacy and safety of indobufen combined with nicorandil in the treatment of unstable angina pectoris(UAP)with high bleeding risk.Methods A toal of 82 UAP patients with high bleeding risk admitted to Yuncheng Central Hospital from January 2023 to April 2024 were retrospectively selected and divided into the control group(n=41)and combination group(n=41)according to treatment methods.In addition to conventional treatment,the patients in the control group received oral administration of aspirin tablets and those in the combination group received that of indobufen tablets combined with nicorandil tablets.The clinical efficacy,fibrinogen(FIB)content,platelet aggregation rate(PAG)and vascular endothelial injury indicators were compared between the two groups.Furthermore,the incidence of adverse reactions were recorded.Results After treatment,the total effective rate was higher in the combination group than in the control(95.12%(39/41)vs 78.05%(32/41),χ^(2)=5.145,P<0.05).The FIB content,PAG and serum homocysteine(Hcy)levels in both groups were lower after than before treatment,and they were lower in the combination group((2.53±0.46)g·L^(-1),(31.75±4.08)%,(18.12±3.81)mmol·L^(-1))than in the control((3.47±0.69)g·L^(-1),(36.24±4.83)%,(20.56±4.25)mmol·L^(-1))(t=7.258,4.547,2.737,all P<0.05).The serum nitric oxide(NO)levels in both groups were higher after than before treatment,and they were higher in the combination group((141.26±14.38)μmol·L^(-1))than in the control((103.48±11.67)μmol·L^(-1))(t=13.062,P<0.05).There was no significant difference in the incidence of bleeding events between the two groups(2.44%,1/41 vs 9.76%,4/41)(χ^(2)=1.917,P>0.05).Conclusion Indobufen combined with nicorandil has better clinical efficacy in the treatment of unstable angina with high bleeding risk since it can effectively improve patients’coagulation function and vascular damage but does not increase the incidence of bleeding events.

关 键 词：不稳定型心绞痛 吲哚布芬 尼可地尔 凝血功能 血管损伤 出血事件 安全性 

分 类 号：R541.4[医药卫生—心血管疾病]