氯吡格雷与依诺肝素钠联用治疗不稳定型心绞痛临床观察

氯吡格雷与依诺肝素钠联用治疗不稳定型心绞痛临床观察

【摘要】目的 观察氯吡格雷联合依诺肝素钠治疗不稳定型心绞痛的临床疗效及对冠心病重要危险因子-血脂的影响。 方法 将108例不稳定型心绞痛患者随机分为治疗组58例和对照组50例，对照组给予依诺肝素钠加阿司匹林，治疗组在对照组治疗基础上加用氯吡格雷。所有病例均于治疗前后分别观察心绞痛发作次数、持续时间和血脂水平等指标。 结果 治疗后，治疗组总有效率(89.7%)明显高于对照组(72%)，两组差异具有统计学意义( P ＜0.05)；两组心绞痛平均发作次数、平均持续时间及治疗组血脂各项指标均较治疗前明显改善，差异有统计学意义( P ＜0.01)；治疗后两组比较，治疗组改善程度优于对照组，差异亦有统计学意义( P ＜0.01)。 结论 氯吡格雷联合依诺肝素钠治疗不稳定型心绞痛疗效确切，可显著改善患者血脂水平。

【Abstract】 Objective To observe clinical efficacy of clopidogrel combined with enoxaprian on unstable angina pectorents(UPA)and their influence on an important risky factor-blood lipids. Methods 108 patients with unstable angina pectorents were randomly divided into the treatment group(58 cases) and the control group (50 cases). Patients of the control group were treated with clopidogrel and aspirin,while patients of the treatment group were given enoxaprian in addition to clopidogrel and aspirin. The index such as the number and duration of angina pectoris attacks, blood lipid levels and other indicators were observed before and after the treatment. Results After treatment, the total effective rate of treatment group was dramatically higher than that of control group.The average number and the average duration of attacks of angina were significantly improvement compared to pretreatment with statistical significance ( P ＜0.01).After treatment, the improvement degree of the treatment group was better than that of the control group, and the difference was also statistically significant ( P ＜0.01). Conclusion Clopidogrel combined with enoxaprian treatment of unstable angina pectorents is an effective,and improve the blood lipid.

【Key words】 Unstable angina pectorents; Clopidogrel; Enoxaprian; Blood lipid

不稳定型心绞痛(Ustable Agina Pctorents,UPA)是急性冠脉综合征的表现形式之一，冠状动脉造影、血管镜及病理学检查结果认为其发病主要由冠状动脉内不稳定斑块引起继发性血栓形成所致［1,2］。病情较重患者常出现预后不良，极易发展为急性心肌梗死和猝死，临床选择安全有效的治疗药物对改善UPA预后具有重要意义。由于UPA中血栓的形成主要涉及血小板聚集和凝血酶激活两个重要环节，故抗血小板和抗凝血在其治疗中起着至关重要的作用。依诺肝素作为低分子肝素的一种，抗凝效果已得到临床广泛认可，而研究表明新型抗血小板聚集药物氯吡格雷也能明显改善不稳定型心绞痛患者的临床症状［3］，二者联用，可针对UPA的发病机制，达到快速有效治疗的目的。我院对2010年1月至2012年1月收治的108例不稳定型心绞痛患者采用氯吡格雷联合依诺肝素钠治疗，获得满意疗效。

1 资料与方法 1.1 一般资料

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