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-β in 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 isosor-bide 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 cardi-ac 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 differ-ence 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-β levels in CHD patients,and the safety is good.
维普
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