吲哚布芬联合智能个体化抗阻训练对 ACS 患者支架术后血小板功能及心血管预后的影响研究

Effect of indobufen combined with intelligent individualized resistance training on platelet function and cardiovascular prognosis after stent implantation in patients with acute coronary syndrome

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目的 探讨吲哚布芬联合智能抗阻训练对急性冠脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后血小板功能及心功能的影响。方法 选取2024年1月至2025年12月在本院接受PCI支架植入术的60例ACS患者,随机分为观察组和对照组,每组30例。对照组给予常规治疗联合氯吡格雷75 mg/d治疗,观察组给予常规治疗联合吲哚布芬(100mg/次,2次/d)+智能抗阻训练干预,两组均连续干预3个月。比较两组患者干预前、干预1个月、3个月时花生四烯酸(AA)诱导和二磷酸腺苷(ADP)诱导的血小板聚集率,随访3个月不良心血管事件(MACE)发生率,以及干预前后心功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)]。结果 干预前两组血小板聚集率、LVEF、LVEDD比较差异无统计学意义(P>0.05);干预1个月、3个月时,观察组AA诱导和ADP诱导的血小板聚集率降低幅度均显著大于对照组(P<0.05);干预3个月后,观察组LVEF显著高于对照组,LVEDD显著低于对照组(P<0.05);随访3个月,两组MACE发生率比较差异无统计学意义(P>0.05)。结论 吲哚布芬联合智能抗阻训练可更显著地抑制ACS患者PCI术后血小板聚集,更有效地改善心功能指标,且安全性良好。
Objective To explore the effect of indobufen combined with intelligent resistance training on platelet function and cardiac function in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). Methods A total of 60 ACS patients who underwent PCI stent implantation in our hospital from January 2024 to December 2025 were selected and randomly divided into an observation group and a control group, with 30 patients in each group. The control group was given conventional treatment combined with clopidogrel 75 mg/d, while the observation group was given conventional treatment combined with indobufen (100 mg/time, twice a day) + intelligent resistance training intervention. Both groups received continuous intervention for 3 months. The arachidonic acid (AA)-induced and adenosine diphosphate (ADP)-induced platelet aggregation rates were compared between the two groups before intervention, 1 month and 3 months after intervention. The incidence of major adverse cardiovascular events (MACE) was followed up for 3 months, and the cardiac function indexes [left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD)] were compared before and after intervention. Results Before intervention, there were no significant differences in platelet aggregation rates, LVEF and LVEDD between the two groups (P > 0.05); at 1 month and 3 months after intervention, the reduction amplitudes of AA-induced and ADP-induced platelet aggregation rates in the observation group were significantly greater than those in the control group (P < 0.05); after 3 months of intervention, LVEF in the observation group was significantly higher than that in the control group, and LVEDD was significantly lower than that in the control group (P < 0.05); after 3 months of follow-up, there was no significant difference in the incidence of MACE between the two groups (P > 0.05). Conclusion Indobufen combined with intelligent resistance training can more significantly inhibit platelet aggregation, more effectively improve cardiac function indexes in ACS patients after PCI, and has good safety.
论著

替格瑞洛与氯吡格雷对住院期间急性冠状动脉综合征患者出血风险的临床研究

Clinical study on risk of bleeding between Ticagrelor and Clopidogrel in inpatient with acute coronary syndrome

:22-24
 
目的 比较替格瑞洛片与氯吡格雷片在临床住院急性冠状动脉综合征患者使用中的出血风险。方法 选择2016年1月—2016年11月于我院心血管内科住院的264例急性冠状动脉综合征患者。将患者随机分为两组,替格瑞洛组(A组)131例,氯吡格雷组(B组)133例。对两组患者出血情况进行比较。结果 住院期间两组患者均无严重心血管不良事件(MACE),均未见黑便及需要输血的严重出血。轻微出血患者数,A组:17例占13.0%(17/131),B组:3例占2.3%(3/133),A组轻微出血风险高于B组,差异有统计学意义(P<0.01)。结论 替格瑞洛轻微出血风险发生率高于氯吡格雷,均未见MACE发生及严重出血病例,临床使用中需注意此问题,并建议更多的临床研究出现。
Objective To compare the risk of bleeding between Clopidogrel and Ticagrelor in inpatients with acute coronary syndrome. Methods 264 patients with acute coronary syndrome who were admitted to our hospital from January 2016 to October 2016 were selected. The patients were divided into two groups randomly, 131 cases with taking Ticagrelor tablets and 133 cases with taking Clopidogrel tablets. The risk of bleeding of the two groups were compared. Results There were no serious adverse cardiovascular events (MACE) between two groups. Severe bleeding events were not obsereved in Ticagrelor and Clopidogrel group. The number of cases with mild bleeding were 17 in Ticagrelor group(13%) and 3 in Clopidogrel group (2.3%). The incidence of minor bleeding risk in Ticagrelor group was significantly higher than the Clopidogrel group(P<0.01). Conclusion The incidence of minor bleeding risk in Ticagrelor group was higher than Clopidogrel.There was no MACE occurrence and serious bleeding among two groups. We need to pay more attention to this problem in clinical use, and more clinical research should be proposed.
临床诊疗

替罗非班辅助低分子肝素治疗急性冠脉综合征合并妊娠糖尿病的前瞻性研究

Prospective study of Tirofiban assist low molecular weight heparin in treatment of acute coronary syndrome combined gestational diabetes

:67-68
 
目的 探讨替罗非班辅助低分子肝素治疗急性冠脉综合征合并妊娠糖尿病的临床疗效及安全性。方法 前瞻性选取本院2012年4月—2015年10月收治的80例急性冠脉综合征合并妊娠糖尿病患者,按随机数字表法分为对照组、实验组,每组40例,实验组采用替罗非班辅助低分子肝素治疗,对照组使用单独低分子肝素治疗方案,比较两组治疗后血浆蛋白-A(PAPP-A)以及超敏C反应蛋白(hs-CRP)水平;比较两组内出血情况以及血小板计数的变化。结果 两组治疗后PAPP-A以及hs-CRP水平均有所下降,实验组下降幅度高于对照组,对比差异有统计学意义(P<0.05);两组内出血发生率分别为10.0%、40.0%,均无严重出血情况发生,实验组轻度出血3例,中度出血1例,对照组轻度出血10例,中度出血6例,实验组轻中度出血率低于对照组(P<0.05);两组治疗前血小板计数对比差异无统计学意义(P>0.05),治疗后实验组血小板计数下降明显,对照组血小板计数无明显变化,两组不同时间点血小板计数差异无统计学意义(P>0.05)。结论 替罗非班辅助低分子肝素治疗急性冠脉综合征合并妊娠糖尿病患者具有一定的效果,且用药安全性较高。
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