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目的观察氯吡格雷联合低分子肝素治疗不稳定型心绞痛(UAP)的临床效果及安全性。方法将236例符合不稳定型心绞痛诊断标准的患者随机分为治疗组(120例)和对照组(116例)。治疗组为在对照组治疗基础上加口服氯吡格雷75 mg,1次/d,共1个月,低分子肝素皮下注射7 d。对照组应用阿司匹林及调脂治疗、硝酸酯类、β-受体阻滞剂、钙离子拮抗剂、血管紧张素转换酶抑制剂(ACEI)等类药物。观察两组心绞痛症状控制情况、心电图改变、主要终点事件及不良反应发生情况。结果治疗组症状、心电图缺血性改变有明显好转(P<0.01),1个月内心肌梗死及心脏猝死等主要终点事件下降,无严重不良反应。结论氯吡格雷联合低分子肝素治疗不稳定型心绞痛是安全有效的。
Objective To observe the clinical effect and safety of clopidogrel plus low molecular weight heparin in the treatment of unstable angina pectoris (UAP). Methods 236 patients with unstable angina pectoris were randomly divided into treatment group (120 cases) and control group (116 cases). The treatment group was treated with clopidogrel 75 mg once daily for 1 month on the basis of the control group, and the low molecular weight heparin was injected subcutaneously for 7 days. The control group used aspirin and lipid-lowering therapy, nitrates, β-blockers, calcium antagonists, angiotensin-converting enzyme inhibitors (ACEI) and other drugs. The two groups were observed angina control symptoms, ECG changes, the main endpoint events and adverse reactions. Results The symptoms of the treatment group and ischemic changes of electrocardiogram were significantly improved (P <0.01). The main end points such as myocardial infarction and sudden cardiac death within one month were decreased without serious adverse reactions. Conclusion Clopidogrel combined with low molecular weight heparin in the treatment of unstable angina pectoris is safe and effective.