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目的观察氯吡格雷联合阿司匹林治疗非血运重建的老年非ST段抬高型急性冠脉综合征(NSTEACS)的疗效和安全性。方法选取非血运重建的老年NSTEACS患者68例,随机分为二组,对照组33例,给予阿司匹林和低分子肝素钙治疗,并根据病情给予硝酸酯类、β受体阻滞剂、钙离子拮抗剂、血管紧张素转换酶抑制剂(ACEI)、他汀类调脂药等常规治疗;治疗组35例,在对照组治疗基础上加用氯吡格雷75mg/d,疗程均为3个月。观察二组治疗前后临床症状的改善、心电图的变化及治疗后3个月内心血管事件发生情况及药物不良反应。结果治疗组临床疗效总有效率88.57%,对照组总有效率66.67%,二组间差异有统计学意义(P<0.05);治疗组3个月内的心血管复合终点事件发生显著低于对照组(P<0.05)。结论氯吡格雷联合阿司匹林治疗非血运重建的老年非ST段抬高型急性冠脉综合征优于单用阿司匹林,较安全。
Objective To observe the efficacy and safety of clopidogrel combined with aspirin in the treatment of non-revascularized elderly non-ST segment elevation acute coronary syndrome (NSTEACS). Methods Sixty-eight elderly patients with non-revascularized NSTEACS were randomly divided into two groups. The control group received aspirin and low-molecular-weight heparin calcium. Nitrates, β-blockers and calcium ions Antagonists, angiotensin converting enzyme inhibitors (ACEI), statin lipid-lowering drugs and other conventional treatment; the treatment group of 35 patients in the control group based on the addition of clopidogrel 75mg / d, treatment were 3 months. Before and after treatment to observe the improvement of clinical symptoms, ECG changes and within 3 months after treatment of cardiovascular events and adverse drug reactions. Results The total effective rate was 88.57% in the treatment group and 66.67% in the control group, with significant difference between the two groups (P <0.05). The incidence of cardiovascular composite end point within 3 months in the treatment group was significantly lower than that in the control group Group (P <0.05). Conclusions Clopidogrel combined with aspirin is superior to aspirin alone in the treatment of non-revascularized elderly non-ST-segment elevation acute coronary syndromes.