高维持量氯吡格雷联合阿司匹林治疗不稳定型心绞痛临床研究

Clinical Study on High Maintenance Dose of Clopidogrel Combined with Aspirin in the Treatment of Unstable Angina Pectoris

目的探讨高维持量氯吡格雷联合阿司匹林治疗不稳定型心绞痛的临床疗效。方法收集2014年10月至2016年10月医院收治的不稳定型心绞痛患者102例,按随机数字表法分为单药组(常规阿司匹林治疗)、常规剂量组(阿司匹林+常规剂量氯吡格雷)、高维持量组(阿司匹林+高维持量氯吡格雷),各34例,治疗4周。结果高维持量组患者的治疗总有效率为100.00%,高于单药组的79.41%和常规剂量组的88.24%(χ~2=-11.093,P=0.000<0.05);高维持量组患者血清中心肌损伤标志物肌酸激酶同工酶(CK-MB)、肌钙蛋白Ⅰ(cTnⅠ)、心脏型脂肪酸结合蛋白(h-FABP)的含量分别为(4.82±0.51)U/L,(0.21±0.03)ng/mL,(0.26±0.04)ng/mL,分别低于单药组、常规剂量组(12.61±1.74)U/L,(0.63±0.08)ng/mL,(0.92±0.11)ng/mL和(9.24±0.95)U/L,(0.44±0.05)ng/mL,(0.51±0.07)ng/mL(F=13.847,9.712,11.047,P=0.000)。结论不稳定型心绞痛患者予高维持量氯吡格雷联合阿司匹林治疗,可有效提高临床疗效,并减少心肌损伤。

Objective To investigate the clinical effect of high maintenance dose of clopidogrel combined with aspirin in the treatment of unstable angina pectoris. Methods Totally 102 patients with unstable angina pectoris admitted to our hospital from October 2014 to October 2016 were selected and divided into single drug group（ conventional aspirin treatment）, conventional dose group（ aspirin ＋ conventional dose of clopidogrel）,and high maintenance dose group（ aspirin ＋ high maintenance dose of clopidogrel） by the random number table method,34 cases in each group. The three groups were treated for 4 weeks. Results The total effective rate in the high maintenance dose group was 100. 00%, which was higher than 79. 41% in the single drug group and 88. 24% in the conventional dose group（ χ~2=-11. 093,P = 0. 000 〈 0. 05）. The contents of myocardial injury markers in serum such as CK-MB, cTn Ⅰ, h-FABP in the high maintenance dose group were（ 4. 82 ± 0. 51） U/L,（ 0. 21 ± 0. 03） ng/mL,（ 0. 26 ± 0. 04） ng/mL,respectively,which were lower than（ 12. 61 ± 1. 74） U/L,（ 0. 63 ± 0. 08） ng/mL,（ 0. 92 ± 0. 11） ng/mL in the single drug group and（ 9. 24 ± 0. 95） U/L,（ 0. 44 ± 0. 05） ng/mL,（ 0. 51 ± 0. 07） ng/mL in the conventional dose group（ F = 13. 847,9. 712,11. 047,P = 0. 000）. Conclusion High maintenance dose of clopidogrel combined with aspirin in the treatment of patients with unstable angina pectoris can effectively improve the clinical effect and reduce the injury of myocardium.