阿司匹林与氯吡格雷双抗联合早期应用血栓通、低分子肝素治疗不稳定心绞痛的疗效和不良反应

摘要

目的 探讨阿司匹林与氯吡格雷双抗联合早期应用血栓通、低分子肝素治疗不稳定心绞痛的疗效和不良反应.方法 选取不稳定心绞痛患者320例,随机分为联合组、肝素组、血栓通组以及对照组.4组均予阿司匹林与氯吡格雷双抗治疗.320例患者在治疗前、后均检测每分输出量(C0)、左室射血分数(LVEF)、每搏输出量(SV)、左室舒张末内径(LVDD)和血小板计数;应用Barthel指数评定4组治疗后的生活质量;记录治疗过程中出现的不良反应.结果 治疗后,联合组的CO、LVEF、SV较其余3组显著增高(P＜0.05或P＜0.01),LVDD显著低于其他3组(P＜0.01),血小板计数4组无显著差异.治疗后,4组不良反应发生情况无显著差异,但联合组生活质量评分较高(P＜0.01).结论 阿司匹林与氯吡格雷双抗联合早期应用血栓通、低分子肝素能提高不稳定心绞痛患者的治疗效果,改善心功能.%Objective To explore the efficacy and adverse effects of aspirin and clopidogrel dual anti-platelet therapy combined with early application of thrombus and low molecular weight heparin in the treatment of patients with unstable angina pectoris.Methods A total of 320 patients with unstable angina pectoris were randomly divided into combined group,heparin group,thrombosis group and control group.The four groups were treated with aspirin and clopidogrel.Before and after treatment,the CO,LVEF,SV,LVDD and platelet count were detected.The quality of life after treatment in the four groups was evaluated by Barthel index,and the adverse reactions during the treatment were recorded.Results After treatment,the CO,LVEF,SV in the combined group were significantly higher than those in the other 3 groups (P ＜0.05 orP ＜0.01),while the LVDD was significantly lower than the other 3 groups (P ＜ 0.01).There was no significant difference of platelet count among the 4 groups.After treatment,there were no significant differences in adverse reactions among the 4 groups,but the quality of life score in the combined group was significantly higher than the other 3 groups (P ＜ 0.01).Conclusion Aspirin and clopidogrel dual anti-platelet therapy combined with early application of thrombus and low molecular weight heparin can effectively improve the therapeutic effect of patients with unstable angina pectoris and improve the cardiac function.