摘要
目的:观察硫酸氢氯吡格雷联合单硝酸异山梨酯对冠心病(CHD)患者细胞外基质金属蛋白酶诱导因子(EMMPRIN)、游离脂肪酸(FFA)、心血管调节肽(salusin-β)水平的影响。方法:选择2019年9月~2021年3月期间海安市人民医院收治的120例CHD患者,根据随机数字表法分为对照组(单硝酸异山梨酯治疗)、联合治疗组(硫酸氢氯吡格雷片联合单硝酸异山梨酯治疗),各60例。对比两组疗效、心功能、血液流变学和EMMPRIN、FFA、salusin-β水平,以及不良反应发生情况。结果:联合治疗组的临床总有效率显著高于对照组(90%比70%,P=0.006)。治疗3个月后,与对照组比较,联合治疗组心排量(CO)[(6.37±0.42)L/min比(8.97±0.52)L/min]、左室射血分数(LVEF)[(56.85±6.28)%比(61.16±7.14)%]、每搏输出量(SV)[(64.55±4.19)ml比(69.74±5.32)ml]显著提高,血浆黏度[(1.58±0.36)mPa·s比(1.09±0.25)mPa·s]、全血黏度[(6.91±0.79)mPa·s比(5.27±0.84)mPa·s]、红细胞压积[(48.17±5.73)%比(42.28±5.88)%]及EMMPRIN[(1.31±0.19)比(1.08±0.18)]、FFA[(0.73±0.16)mmol/L比(0.54±0.15)mmol/L]、salusin-β[(3.59±0.49)nmol/L比(2.87±0.42)nmol/L]水平均显著降低(P均<0.001)。两组不良反应发生率比较无统计学差异(P=0.591)。结论:硫酸氢氯吡格雷片联合单硝酸异山梨酯治疗CHD患者,可有效改善患者心功能和血液流变学,同时可降低EMMPRIN、FFA、salusin-β水平,安全性较好。
Objective:To observe the effect of clopidogrel bisulfate combined with isosorbide mononitrate on levels of extracellular matrix metalloproteinase inducer(EMMPRIN),free fatty acid(FFA)and salusin-βin patients with coronary heart disease(CHD).Methods:This randomized controlled study enrolled 120 CHD patients admitted Hai'an People's Hospital between September 2019 and March 2021.The patients were divided into control group(n=60,isosorbide mononitrate therapy)and combined treatment group(n=60,clopidogrel bisulfate combined with isosorbide mononitrate).Therapeutic effect,cardiac function,hemorheology,levels of EMMPRIN,FFA and salusin-β,and incidence of adverse reactions were compared between two groups.Results:Total effective rate in combined treatment group was significantly higher than that of control group(90%vs.70%,P=0.006).After 3-month treatment,compared with patients in control group,those in combined treatment group had significant higher cardiac output(CO)[(6.37±0.42)L/min vs.(8.97±0.52)L/min],left ventricular ejection fraction(LVEF)[(56.85±6.28)%vs.(61.16±7.14)%]and stroke volume(SV)[(64.55±4.19)ml vs.(69.74±5.32)ml],and significant lower plasma viscosity[(1.58±0.36)mPa·s vs.(1.09±0.25)mPa·s],whole blood viscosity[(6.91±0.79)mPa·s vs.(5.27±0.84)mPa·s],hematocrit[(48.17±5.73)%vs.(42.28±5.88)%],levels of EMMPRIN[(1.31±0.19)vs.(1.08±0.18)],FFA[(0.73±0.16)mmol/L vs.(0.54±0.15)mmol/L]and salusin-β[(3.59±0.49)nmol/L vs.(2.87±0.42)nmol/L](P<0.001 all).We detected no significant difference in incidence of adverse reactions between two groups(P=0.591).Conclusion:Clopidogrel bisulfate combined with isosorbide mononitrate can effectively improve cardiac function and hemorheology,and reduce EMMPRIN,FFA and salusin-βlevels in CHD patients,and the safety is good.
作者
陈静静
唐佳佳
丁佐慧
缪雄
CHEN Jing-jing;TANG Jia-jia;DING Zuo-hui;MIAO Xiong(Department of Pharmacy,Hai'an People's Hospital,Nantong,Jiangsu,226600,China)
出处
《心血管康复医学杂志》
CAS
2024年第6期748-752,共5页
Chinese Journal of Cardiovascular Rehabilitation Medicine
关键词
冠心病
脂肪酸类
非酯化
氯吡格雷
单硝酸异山梨酯
Coronary disease
Fatty acids,nonesterified
Clopidogrel
Isosorbide mononitrate
