阿托伐他汀联合氯吡格雷治疗老年人心绞痛疗效观察

Effect of atorvastatin combined with clopidogrel in the treatment of elderly patients with angina pectoris

目的 探讨阿托伐他汀联合氯吡格雷治疗老年人心绞痛的疗效和安全性.方法 90例老年心绞痛患者按数字表法随机分为观察组和对照组,每组45例.所有患者均应用常规和阿托伐他汀治疗,观察组在此基础上加用氯吡格雷.比较两组治疗前后TC、TG、HDL-C、LDL-C、心绞痛发作次数、持续时间及不良反应、心脏不良事件,并评价疗效.结果 观察组总有效率为93.3％（42/45）,对照组为75.6％（34/45）,差异有统计学意义（x2=5.67,P ＜0.05）.两组治疗后TC、TG、HDL-C、LDL-C均较治疗前显著改善（t=5.34、4.78、4.56、4.92、4.31、3.92、4.11、4.62,均P＜0.05）,观察组改善显著优于对照组（t=4.20、4.08、3.98、4.03,均P＜0.05）.两组治疗后心绞痛发作次数和持续时间均较治疗前显著下降（t=6.22、5.78、4.12、4.02,均P＜0.05）,且观察组较对照组下降更为显著（t=4.23、3.99,均P＜0.05）.观察组不良反应3例,心脏不良事件1例,对照组不良反应2例,心脏不良事件3例.结论 阿托伐他汀联合氯吡格雷治疗老年人心绞痛既能调脂,又能改善心绞痛症状.

Objective To investigate the efficacy and safety of atorvastatin combined with clopidogrel in the treatment of elderly patients with angina pectoris. Methods 90 elderly patients with angina pectoris were randomly divided into the observation group and control group, 45 cases in each group. All patients were given conventional treatment and atorvastafin,the observation group was given clopidogrel based on this. The TC ,TG, HDL-C, LDL-C, angina attack frequency, duration and adverse reactions, adverse cardiac events of two groups before and after treatment were compared,and the clinical effect was evaluated. Results The total effective rate of the observation group was 9 3.3 % （42/45） , whichwassignificantlyhigherthan75.6% （ 34/45 ） inthecontrolgroup （X2 = 5.67, P 〈 0.05 ）. After treatment, the TC, TG, HDL-C, LDL-C of two groups were significantly improved than before treatment （ t = 5.34,4.78,4.56,4.92,4.31,3.92,4.11,4.62, all P 〈 0.05 ）, the improvement in the observation group was signifi- cantly better than that in the control group（t = 4.20,4.08,3.98,4.03, all P 〈 0.05 ）. After treatment, the angina attack frequency and duration of two groups were significantly decreased compared with before treatment （ t = 6.22, 5.78,4.12,4.02, all P 〈 0.05 ）, and the observation group decreased significantly than the control group （ t = 4.23, 3.99, all P 〈 0.05 ）. 3 cases of adverse reactions and 1 case of adverse cardiac events occurred in observation group, 2 cases of adverse reaction and 3 cases of adverse cardiac events occurred in control group. Conclusion Atorvastatin combined with clopidogrel in the treatment of elderly patients with angina pectoris can regulate blood lipid and im- prove the symptoms of angina pectoris.