冠心病心绞痛患者应用小剂量氯比格雷联合消心痛与阿司匹林治疗的效果观察(1)
摘要：目的 探讨冠心病心绞痛患者应用小剂量氯比格雷联合消心痛与阿司匹林治疗的效果。方法 抽取我院收治的60例冠心病心绞痛患者作为此次研究对象，通过回顾分析法随机分为治疗组与对照组，两组各30例。对照组给予消心痛(硝酸异山梨醇酯)+阿司匹林治疗，治疗组给予小剂量氯比格雷+消心痛+阿司匹林联合治疗，对比两组患者治疗后的临床效果。结果 通过不同的方法进行治疗后，两组患者的临床症状均得到有效的改善。其中治疗组患者的治疗有效率高于对照组(P<0.05)。对照组患者的心绞痛发作次数以及发作时持续时长均比治疗组高，组间数据对比差异性明显(P<0.05)。结论 对冠心病心绞痛患者采用小剂量氯比格雷联合消心痛与阿司匹林治疗，可改善患者临床症状以及减少心绞痛发作频率，效果显著，可推广应用。
关键词：冠心病；心绞痛；小剂量氯比格雷；消心痛；阿司匹林
Effect of Low-dose Clopidogrel Combined with Aspirin and Aspirin in Patients with Coronary Heart Disease and Angina Pectoris
, http://www.100md.com
ZENG Li
(Department of Internal Medicine，Ya'an People's Hospital，Ya'an 625100，Sichuan，China)
Abstract：Objective To explore the application of coronary heart disease angina pectoris patients with small dose of aspirin and clopidogrel combined with isosorbide dinitrate treatment.Methods 60 cases of angina pectoris were selected from our hospital as the research object，through the retrospective analysis method were randomly divided into treatment group and control group，two groups of 30 cases each.The control group was given isosorbide dinitrate(isosorbide dinitrate ester)+aspirin treatment，the treatment group was given low-dose clopidogrel+aspirin+isosorbide dinitrate combined treatment，clinical effect of the two groups were compared after treatment.Results By different methods of treatment，clinical symptoms of the two groups of patients were improved.The effective rate of treatment group was higher than the control group(P<0.05).The control group of patients with anginal attacks and attack duration were higher than the treatment group，the differences between group data significantly(P<0.05).Conclusion For patients with angina pectoris of coronary heart disease using small doses of clopidogrel combined with isosorbide dinitrate and aspirin therapy can improve clinical symptoms of patients with angina and reduce seizure frequency，the effect is significant，worthy of clinical application.
, 百拇医药
Key words：Coronary heart disease；Angina pectoris；Low dose clopidogrel；Isosorbide dinitrate；Aspirin
冠狀动脉粥样硬化性心脏病是因冠状动脉粥样硬化使血管腔狭窄或阻塞，或(和)冠状动脉功能性改变(如痉挛)导致心肌缺血、缺氧或坏死而引起的心脏病，可分为无症状心肌缺血、心绞痛、心肌梗塞、缺血性心肌病、猝死五种类型。近年趋向于根据发病特点和治疗原则的不同分为慢性冠脉病和急性冠脉综合征。心绞痛发生主要是在冠状动脉机械狭窄的基础上，当人体在情绪激动(如愤怒、焦急、过度兴奋)、劳累、饱食、受寒、吸烟、心动过速等诱因下，心肌耗氧量急剧增加，导致冠状动脉供氧与心肌耗氧之间发生矛盾是发病主要原因之一。同时由于冠状动脉发生炎症性、增生性与退化性变病，受损的血管内膜暴露引起血小板的集聚，形成血栓及粥样斑块破裂进一步加重管腔的狭窄也是发病的重要原因。冠心病心绞痛患者的主要临床症状为阵发性前胸压榨性疼痛，疼痛发生于劳力或激动的当时，而不是劳累以后，早晨和上午是好发时段，其余还有气短、心悸以及胸闷等症状[1]。心绞痛的治疗有两个目的：①预防心肌梗塞和猝死，改善预后；②减轻症状，提高生活质量。临床上一般使用硝酸酯类(硝酸甘油、硝酸异山梨醇酯)、β-受体阻断剂(美托洛尔)、钙通道阻断剂(如地尔硫卓、硝苯地平、氨氯地平)治疗，控制心绞痛发作症状，同时需联合使用抗血小板治疗及其他治疗改善预后。近几年，冠心病心绞痛的患病率逐年增加，若不积极加以治疗，病情会逐渐进展并可能引发急性冠脉综合症危及生命，对人们的身心健康均产生了极大危害。本文主要将我院收治的60例冠心病心绞痛患者作为此次研究对象，对冠心病心绞痛患者采用小剂量氯比格雷联合消心痛与阿司匹林治疗，现报告如下。, 百拇医药(曾丽)
关键词：冠心病；心绞痛；小剂量氯比格雷；消心痛；阿司匹林
Effect of Low-dose Clopidogrel Combined with Aspirin and Aspirin in Patients with Coronary Heart Disease and Angina Pectoris
, http://www.100md.com
ZENG Li
(Department of Internal Medicine，Ya'an People's Hospital，Ya'an 625100，Sichuan，China)
Abstract：Objective To explore the application of coronary heart disease angina pectoris patients with small dose of aspirin and clopidogrel combined with isosorbide dinitrate treatment.Methods 60 cases of angina pectoris were selected from our hospital as the research object，through the retrospective analysis method were randomly divided into treatment group and control group，two groups of 30 cases each.The control group was given isosorbide dinitrate(isosorbide dinitrate ester)+aspirin treatment，the treatment group was given low-dose clopidogrel+aspirin+isosorbide dinitrate combined treatment，clinical effect of the two groups were compared after treatment.Results By different methods of treatment，clinical symptoms of the two groups of patients were improved.The effective rate of treatment group was higher than the control group(P<0.05).The control group of patients with anginal attacks and attack duration were higher than the treatment group，the differences between group data significantly(P<0.05).Conclusion For patients with angina pectoris of coronary heart disease using small doses of clopidogrel combined with isosorbide dinitrate and aspirin therapy can improve clinical symptoms of patients with angina and reduce seizure frequency，the effect is significant，worthy of clinical application.
, 百拇医药
Key words：Coronary heart disease；Angina pectoris；Low dose clopidogrel；Isosorbide dinitrate；Aspirin
冠狀动脉粥样硬化性心脏病是因冠状动脉粥样硬化使血管腔狭窄或阻塞，或(和)冠状动脉功能性改变(如痉挛)导致心肌缺血、缺氧或坏死而引起的心脏病，可分为无症状心肌缺血、心绞痛、心肌梗塞、缺血性心肌病、猝死五种类型。近年趋向于根据发病特点和治疗原则的不同分为慢性冠脉病和急性冠脉综合征。心绞痛发生主要是在冠状动脉机械狭窄的基础上，当人体在情绪激动(如愤怒、焦急、过度兴奋)、劳累、饱食、受寒、吸烟、心动过速等诱因下，心肌耗氧量急剧增加，导致冠状动脉供氧与心肌耗氧之间发生矛盾是发病主要原因之一。同时由于冠状动脉发生炎症性、增生性与退化性变病，受损的血管内膜暴露引起血小板的集聚，形成血栓及粥样斑块破裂进一步加重管腔的狭窄也是发病的重要原因。冠心病心绞痛患者的主要临床症状为阵发性前胸压榨性疼痛，疼痛发生于劳力或激动的当时，而不是劳累以后，早晨和上午是好发时段，其余还有气短、心悸以及胸闷等症状[1]。心绞痛的治疗有两个目的：①预防心肌梗塞和猝死，改善预后；②减轻症状，提高生活质量。临床上一般使用硝酸酯类(硝酸甘油、硝酸异山梨醇酯)、β-受体阻断剂(美托洛尔)、钙通道阻断剂(如地尔硫卓、硝苯地平、氨氯地平)治疗，控制心绞痛发作症状，同时需联合使用抗血小板治疗及其他治疗改善预后。近几年，冠心病心绞痛的患病率逐年增加，若不积极加以治疗，病情会逐渐进展并可能引发急性冠脉综合症危及生命，对人们的身心健康均产生了极大危害。本文主要将我院收治的60例冠心病心绞痛患者作为此次研究对象，对冠心病心绞痛患者采用小剂量氯比格雷联合消心痛与阿司匹林治疗，现报告如下。, 百拇医药(曾丽)
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