氯吡格雷联合血栓通注射液治疗不稳定型心绞痛的临床疗效及其对血液流变学指标的影响

摘要

Objective To investigate the clinical effect of clopidogrel combined with xueshuantong injection on unstable angina pectoris and its impact on hemodynamic index. Methods A total of 104 patients with unstable angina pectoris were selected in the People's Hospital of Kai County from 2012 to 2014,and they were divided into control group and treatment group according to random number table,each of 52 cases. After admission,all of the patients stayed in bed for rest,received continuous low - flow oxygen inhalation,low - fat diet and conventional medical treatment,while patients of treatment group received extra clopidogrel sulfate combined with xueshuantong injection;both groups treated for 2 weeks. Clinical effect,attack frequency and duration of angina pectoris,nitroglycerin dosage,index of heart rate variability( including SDNN,SDANN, RMSSD and PNN50)and hemodynamic index(including fibrinogen,whole blood high shear viscosity,whole blood low shear viscosity and plasma viscosity)before and after treatment were compared between the two groups. Results The clinical effect of treatment group was statistically significantly better than that of control group(u = 11. 28,P ﹤ 0. 05). No statistically significant differences of attack frequency or duration of angina pectoris,or nitroglycerin dosage was found between the two groups before treatment(P ﹥ 0. 05);after treatment,attack frequency of angina pectoris and nitroglycerin dosage of treatment group were statistically significantly lower than those of control group,and duration of angina pectoris of treatment group was statistically significantly shorter than that of control group(P ﹤ 0. 05). No statistically significant differences of SDNN,SDANN,RMSSD or PNN50 was found between the two groups before treatment( P ﹥ 0. 05);while SDNN,SDANN,RMSSD and PNN50 of treatment group were statistically significantly higher than those of control group after treatment( P ﹤ 0. 05). No statistically significant differences of fibrinogen,whole blood high shear viscosity,whole blood low shear viscosity or plasma viscosity was found between the two groups before treatment(P ﹥ 0. 05);while fibrinogen,whole blood high shear viscosity,whole blood low shear viscosity and plasma viscosity of treatment group were statistically significantly lower than those of control group after treatment(P ﹤ 0. 05). Conclusion Clopidogrel combined with xueshuantong injection has certain clinical effect in treating unstable angina pectoris,can effectively improve the hemodynamic index.%目的：探究氯吡格雷联合血栓通注射液治疗不稳定型心绞痛（UAP）的临床疗效及其对血液流变学指标的影响。方法选取2012—2014年开县人民医院心内科门诊和病房收治的 UAP 患者104例，按照随机数字表法分为治疗组和对照组，每组52例。患者入院后均嘱其卧床休息、持续低流量吸氧、低脂饮食，并给予常规药物治疗，治疗组患者在此基础上给予硫酸氯吡格雷联合血栓通注射液治疗；两组患者均连续治疗2周。比较两组患者临床疗效，治疗前后心绞痛发作频率、心绞痛持续时间、硝酸甘油用量、心率变异性（HRV）指标〔RR 间期的标准差（SDNN）、RR 间期平均值标准差（SDANN）、相邻 RR 间期差值的均方根（RMSSD）及相邻 NN 之差﹥50 ms 的个数占总窦性心搏个数的百分比（PNN50）〕和血液流变学指标（纤维蛋白原、全血高切黏度、全血低切黏度和血浆黏度）。结果治疗组患者临床疗效优于对照组（u ＝11.28，P ﹤0.05）。治疗前两组患者心绞痛发作频率、心绞痛持续时间、硝酸甘油用量比较，差异无统计学意义（P ﹥0.05）；治疗后治疗组患者心绞痛发作频率、硝酸甘油用量少于对照组，心绞痛持续时间短于对照组（P ﹤0.05）。治疗前两组患者 SDNN、SDANN、RMSSD 及 PNN50比较，差异无统计学意义（ P ﹥0.05）；治疗后治疗组患者 SDNN、SDANN、RMSSD 及 PNN50高于对照组（P ﹤0.05）。治疗前两组患者纤维蛋白原、全血高切黏度、全血低切黏度和全血黏度比较，差异无统计学意义（P ﹥0.05）；治疗后治疗组患者纤维蛋白原、全血高切黏度、全血低切黏度和全血黏度低于对照组（P ﹤0.05）。结论氯吡格雷联合血栓通注射液治疗 UAP 的临床疗效确切，且能有效改善患者的血液流变学指标。