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目的观察氯吡格雷联合硝酸异山梨酯治疗不稳定型心绞痛(unstable angina pectoris,UAP)的临床疗效。方法选择2009年3月—2012年3月收治的UAP患者65例,随机分为对照组32例和观察组33例。对照组口服硝酸异山梨酯每次10 mg,3次/d,服用3个月;观察组在对照组基础上加服氯吡格雷75 mg,1次/d,服用3个月。比较两组治疗前后血压、心率和心电图,并记录不良反应的发生情况。结果心绞痛症状改善情况:有效率对照组53.13%,观察组75.76%,两组比较差异有统计学意义(P<0.05)。心电图改善情况:有效率对照组50.00%,观察组72.73%,两组比较差异有统计学意义。两组均未出现严重不良反应。结论氯吡格雷联合硝酸异山梨酯在缓解心绞痛、改善心肌缺血方面明显优于单用硝酸异山梨酯,是治疗UAP较为理想安全的药物。
Objective To observe the clinical efficacy of clopidogrel combined with isosorbide dinitrate in the treatment of unstable angina pectoris (UAP). Methods Sixty-five UAP patients who were admitted from March 2009 to March 2012 were randomly divided into control group (32 cases) and observation group (33 cases). The control group was given isosorbide dinitrate 10 mg every 3 times for 3 months. The observation group was given clopidogrel 75 mg once daily for 3 months on the basis of the control group. Before and after treatment, blood pressure, heart rate and ECG were compared, and the incidence of adverse reactions was recorded. Results The improvement of angina pectoris was 53.13% in the effective control group and 75.76% in the observation group, with significant difference between the two groups (P <0.05). ECG improvement: efficient control group 50.00%, observation group 72.73%, the difference between the two groups was statistically significant. No serious adverse reactions occurred in either group. Conclusion Clopidogrel combined with isosorbide dinitrate is superior to isosorbide dinitrate alone in relieving angina pectoris and improving myocardial ischemia. It is an ideal and safe drug for UAP.