丹参酮ⅡA磺酸钠、低分子肝素联合治疗老年不稳定性心绞痛临床观察

Clinical observation of tanshinone ⅡA sulfonate and low molecular weight heparin in the treatment of senile unstable angina

目的探讨丹参酮ⅡA磺酸钠、低分子肝素联合治疗老年不稳定性心绞痛的疗效与安全性。方法选择老年不稳定性心绞痛患者78例,随机分为对照组(36例)和观察组(42例),对照组在常规应用硝酸酯类、血管紧张素转换酶抑制剂、β-受体阻滞剂、阿司匹林肠溶片和(或)钙离子拮抗剂的基础上加用低分子肝素0.4～0.6mL,1次/12h,皮下注射,连用7d;观察组在上述基础上加用5%葡萄糖注射液250mL+丹参酮ⅡA磺酸钠40mg静点,1次/d,连用10d。观察治疗前后临床疗效及对凝血功能的影响。结果治疗后观察组心绞痛改善总有效率为91.7%,对照组心绞痛改善总有效率为80.0%,两组比较差异有统计学意义(P<0.05)。观察组和对照组两组治疗后的纤维蛋白原含量均较治疗前显著降低,经比较差异有统计学意义(P<0.05)。两组治疗后的凝血活酶时间、凝血酶原时间、凝血酶时间、血小板计数及血小板聚集率与治疗前相比,均无明显变化。结论丹参酮ⅡA磺酸钠、低分子肝素联合治疗老年人不稳定性心绞痛疗效确切、安全,值得推广。

Objective To investigate the efficacy and safety of tanshinone Ⅱ A sulfonic sodium and low molecular weight heparin in the treatment of senile unstable angina.Methods 78 aged cases with unstable angina were selected and randomly divided into control group（n=36）and observation group（n=42）.The control group was treated by conventional nitrates,converting enzyme inhibitor,β-receptor blockers,aspirin enteric-coated tablets and/or calcium antagonists on the foundation with low molecular weight heparin 0.4 ～ 0.6 mL,1/12 hours,subcutaneous injection,for 7 days;The observation group was treated by the same methods with the control group,in addition to that,the observation group was also used 5% glucose injection with 250 mL＋ A sulfonate 40 mg static point,once a day,for 10 days.Observing the clinical efficacy and on coagulation before and after the treatment.Results After the treatment,the total efficiency of the observation group was 91.7%,and the control group was 80.0%,there had significant difference（P 0.05）.After the treatment,the fibrinogen content of the two groups was both significantly lower than before the treatment（P 0.05）.Thromb-oplastin time,prothrombin time,thrombin time,platelet count and platelet aggregation rate had no significant change.Conclusion It＇s safe and effective of tanshinone Ⅱ sulfonate and low molecular weight heparin in the treatment of senile unstable angina,it＇s worthy for clinical.