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目的:探讨麝香保心丸对急性冠脉综合征(ACS)患者氯吡格雷抵抗的影响。方法:选取2012年2月至2014年12月我院收治的ACS且发生氯吡格雷抵抗的患者131例作为研究对象。按照随机数字表法将患者均分为治疗组和对照组,治疗组患者例数为66例,对照组患者例数为65例。治疗组患者采取氯吡格雷联合麝香保心丸治疗,对照组患者采取氯吡格雷治疗,观察两组患者血小板聚集率、血小板抑制率、心率变异(HRV)情况、血清MMP-2水平变化情况。结果:治疗后,治疗组患者血小板聚集率,显著优于治疗前(P<0.05);治疗后,治疗组患者血小板抑制率,显著优于治疗前(P<0.05)。治疗后,治疗组患者血小板聚集率显著优于对照组(P<0.05);治疗后,治疗组患者血小板抑制率显著高于对照组(P<0.05),治疗前,两组患者血清MMP-2水平差异无统计学意义,治疗后,治疗组患者血清MMP-2水平显著优于治疗前(P<0.05);治疗后,治疗组患者血清MMP-2水平与对照组比较,显著优于对照组(P<0.05),治疗前,两组患者HRV情况差异无统计学意义,治疗后,治疗组患者HRV情况显著优于治疗前(P<0.05);治疗后,治疗组患者HRV情况显著优于对照组(P<0.05)。结论:麝香保心丸对急性冠脉综合征患者氯吡格雷抵抗有一定的影响,能够改善机体血小板聚集率、血小板抑制率、心率变异(HRV)及血清MMP-2水平。
Objective: To investigate the effect of Shexiang Baoxin Pill on clopidogrel resistance in patients with acute coronary syndrome (ACS). Methods: A total of 131 patients with resistance to clopidogrel who received ACS in our hospital from February 2012 to December 2014 were selected as the study subjects. According to the random number table, the patients were divided into treatment group and control group. The number of patients in the treatment group was 66 cases and that of the control group was 65 cases. Patients in the treatment group were treated with clopidogrel combined with Shexiang Baoxin Pill. Patients in the control group were treated with clopidogrel. The platelet aggregation rate, platelet inhibition rate, heart rate variability (HRV) and serum MMP-2 levels were observed in two groups. Results: After treatment, the platelet aggregation rate in the treatment group was significantly better than that before treatment (P <0.05). After treatment, the platelet inhibition rate in the treatment group was significantly better than that before treatment (P <0.05). After treatment, the platelet aggregation rate of the treatment group was significantly better than that of the control group (P <0.05). After treatment, the platelet inhibition rate of the treatment group was significantly higher than that of the control group (P <0.05). Before treatment, the serum MMP-2 After treatment, the level of serum MMP-2 in the treatment group was significantly better than that before treatment (P <0.05). After treatment, the serum MMP-2 level in the treatment group was significantly better than that in the control group (P <0.05). Before treatment, there was no significant difference in HRV between the two groups. After treatment, HRV in the treatment group was significantly better than that before treatment (P <0.05). After treatment, HRV in the treatment group was significantly better than that before treatment Control group (P <0.05). Conclusion: Shexiang Baoxin Pill has certain effect on clopidogrel resistance in patients with acute coronary syndrome, and can improve the platelet aggregation rate, platelet inhibition rate, heart rate variability (HRV) and serum MMP-2 level.