不同抗栓方案治疗老年不稳定型心绞痛的临床观察

Clinical efficiency of different antithrombotic schemes in the treatment of elderly patients with unstable angina pectoris

目的观察三种不同抗栓方案治疗老年不稳定型心绞痛(UAP)的临床疗效。方法将242例不稳定型心绞痛患者分为3组;阿司匹林组(A组)82例,阿司匹林加氯吡格雷组(B组)76例,阿司匹林加氯吡格雷加低分子肝素组(C组)84例,观察治疗前后临床疗效、心绞痛发作次数、持续时间及硝酸甘油的用量。结果临床疗效C组优于A组和B组(P<0.01),而B组又优于A组(P<0.05);治疗后心绞痛发作次数、持续时间及硝酸甘油的用量3组均明显减少,治疗前后比较差异有统计学意义(P<0.01),且C组明显少于A组和B组(P<0.01),B组又少于A组(P<0.01)。心脏事件发生率C组明显低于A组及B组。结论阿司匹林、氯吡格雷与低分子肝素联合治疗老年UAP是安全有效的。

Objective To observe the therapeutic effects of three kinds of different antithrombotic schemes on elderly patients with unstable angina pectoris（UAP）. Methods 242 patients with UAP were randomly divided into 3 groups：82 patients in group A were treated with aspirin;76 patients in group B were treated with aspirin ＋ clopidegrel;84 patients in group C were treated with aspirin ＋ clopidegrel ＋ low molecular weight heparin. The therapeutic effects before and after the treatment, the frequency and duration of angina pectoris attacks and the dosage of nitroglycerin were observed for both groups. Results The clinical effects in group C were superior to those in group A and group B （ P 〈0.01 ） ,while the effects in group B were better than those of group A （ P 〈 0. 05 ）. As compared with those before treatment, the frequency and duration of angina pectoris, nitroglycerin dosage were obviously decreased in the three groups after treatment （ P 〈0.01 ） ,furthermore,which in group C were significantly lower than those in group A and group B （ P 〈 0.01 ）, and which in group B were significantly lower than those in group A （ P 〈 0.01 ）. The incidence of cardiac event in group C was significantly lower than that in group A and group B （ P 〈 0.01 ）. Conclusion The combined application of aspirin, elopidegrel and low molecular weight heparin is safe and effective in treating senile UPA.