氯吡格雷联合阿司匹林对急性心肌梗死伴心力衰竭患者运动耐力及炎症指标的影响

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摘要目的探讨氯吡格雷与阿司匹林联用对急性心肌梗死伴心力衰竭患者运动耐力及炎症指标的影响。方法选取2016年1月～2019年8月在南京市栖霞区医院就诊的82例急性心肌梗死伴心力衰竭患者作为研究对象，采用随机数字表法将其分为对照组与观察组，每组各41例。对照组患者单独采用阿司匹林治疗，观察组患者在对照组的基础上加用氯吡格雷治疗，两组均治疗3个月。比较两组患者的临床疗效、运动耐力及炎症指标。结果观察组患者的治疗总有效率为95.12%，高于对照组的78.05%，差异有统计学意义（P＜0.05）。治疗1个月时，两组患者的持续运动时间（ED）、耗氧量峰值（VO2peak）及无氧代谢阈值（AT）比较，差异无统计学意义（P＞0.05）。治疗3个月时，两组患者的ED、VO2peak、AT水平均高于治疗1个月时，差异有统计学意义（P＜0.05）；治疗3个月时，观察组患者的ED、VO2peak、AT水平均高于对照组，差异有统计学意义（P＜0.05）。治疗前，两组患者的血清白细胞介素-6（IL-6）、肿瘤坏死因子α（TNF-α）及C-反应蛋白（CRP）水平比较，差异无统计学意义（P＞0.05）。治疗3个月时，两组患者的血清IL-6、TNF-α 及CRP水平均低于治疗前，差异有统计学意义（P＜0.05）；治疗3个月时，观察组患者的IL-6、TNF-α 及CRP水平均低于对照组，差异有统计学意义（P＜0.05）。结论氯吡格雷与阿司匹林联用可降低急性心肌梗死伴心力衰竭患者的炎症指标水平，进一步改善运动耐力，提高治疗效果。

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	李开桥

关键词 ：氯吡格雷, 阿司匹林, 急性心肌梗死, 心力衰竭, 运动耐力, 炎症指标

Abstract：Objective To investigate the effect of Clopidogrel combined with Aspirin on exercise tolerance and inflammation indexes in patients with acute myocardial infarction and heart failure.Methods A total of 82 patients with acute myocardial infarction and heart failure who were treated in Qixia District Hospital of Nanjing City from January 2016 to August 2019 were selected as the research objects.They were divided into the control group and the observation group according to random number table method，with 41 cases in each group.The control group was treated with Aspirin alone，and the observation group was treated with Clopidogrel on the basis of the control group.Two groups were both treated for 3 months.The clinical efficacy，exercise endurance and inflammation indexes at 1 and 3 months of treatment were compared between the two groups.Results The total effective rate of clinical treatment in the observation group (95.12%) was higher than that in the control group (78.05%)，and the difference was statistically significant (P＜0.05).There were no statistically significant differences in continuous exercise time (ED) and peak oxygen consumption (VO2peak) and anaerobic metabolism threshold (AT) levels between the two groups at 1 months of treatment (P＞0.05).At 3 months of treatment，the ED，VO2peak and AT of the two groups were higher than those at 1 months of treatment，and the differences were statistically significant (P＜0.05).At 3 months of treatment，the ED，VO2peak and AT of the observation group were higher than those of the control group，and the differences were statistically significant (P＜0.05).There were no statistically significant differences in serum interleukin-6 (IL-6)，tumors necrosis factor-α (TNF-α) and C-reactive protein (CRP) between the two groups before treatment (P＞0.05).At 3 months of treatment，the IL-6，TNF-α and CRP of the two groups were lower than those before treatment，and the differences were statistically significant (P＜0.05).At 3 months of treatment，the IL-6，TNF-α and CRP of the observation group were lower than those of the control group，and the differences were statistically significant (P＜0.05).Conclusion The combined treatment of Clopidogrel and Aspirin can reduce the level of inflammatory indexes in patients with acute myocardial infarction and heart failure，further improve exercise endurance and improve the therapeutic effect.

Key words： Clopidogrel Aspirin Acute myocardial infarction Heart failure Exercise endurance Inflammation index

作者简介: 李开桥（1981-），男，汉族，江苏南京人，本科，研究方向：心内科学

引用本文:

李开桥. 氯吡格雷联合阿司匹林对急性心肌梗死伴心力衰竭患者运动耐力及炎症指标的影响[J]. 中国当代医药, 2020, 27(33): 66-69.
LI Kai-qiao. Effect of Clopidogrel combined with Aspirin on exercise endurance and inflammatory indexes in patients with acute myocardial infarction and heart failure. 中国当代医药, 2020, 27(33): 66-69.

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https://www.dangdaiyiyao.com/CN/ 或 https://www.dangdaiyiyao.com/CN/Y2020/V27/I33/66

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