氯吡格雷辛伐他汀联合低分子肝素治疗不稳定型心绞痛疗效分析

摘要

Objective To investigate the basis of clopidogrel combined with simvastatin and low - molecular - weight heparin in the treatment of unstable angina in elderly efficacy and safety. Methods 110 cases of senile unstable angina were randomly divided into 3 groups, A group for the conventional treatment group, to the oral simvastatin 20rag QN; B Group, clopidogrel 75rag Qd in addition to the drug used in A group; C Group,subcutaneous low molecular weight heparin to the abdominal wall 0.4nd Q12h on the base of treatment in B Group. Two weeks of treatment. Nitrattes, ACEI - type, calcium antagonists or β - blockers were give in each group. Results The total effective rates were 59.3% , 63.6% , 89.7% in A, B, C group, respectively; the total efficiency in C group was significantly different (P < 0.01, P < 0.05 ). After 2 months follow -up, the incidence of acute cardiac events in C group was significantly different ( P < 0.05) compared with that in A group, but compared with B group, there was no significant difference (P > 0. 05 ). There were no significant differences ( P > 0.05 ) for the adverse, reactions among the 3 groups. Conclusion The combined use of elopidogrel, simvastatin and low -molecular -weight heparin in treating senile unstable angina pectoris is accurate, safe and can reduce the incidence of acute cardiac events.%目的 观察氯吡格雷与辛伐他汀合用基础上使用低分子肝素治疗老年不稳定心绞痛疗效及安全性.方法 老年不稳定心绞痛110例随机分成3组,A组为常规治疗组,予口服辛伐他汀20mg,每晚1次;B组为A组加服氯吡格雷75mg,1次/d;C组在B组基础上给腹壁皮下注射低分子肝素0.4ml,1次/12h.疗程均为2周.各组均给予硝酸酯类、ACEI类、钙拮抗剂或β受体阻滞剂.结果 A、B、C 3组总有效率分别为59.3%、63.6%、89.7%,C组总有效率与A组、B组比较,差异有统计学意义(P<0.01,P<0.05).随访2个月,C组急性心脏事件发牛率与A组比较,差异有统计学意义(P<0.05),与B组差异无统计学意义(P>0.05).不良反应,3组间差异均无统计学意义(P>0.05).结论 氯吡格雷、辛伐他汀与低分子肝素联合治疗老年不稳定心绞痛疗效确切、安全,能减少急性心脏事件发生率.