氯吡格雷联合阿托伐他汀治疗老年不稳定性心绞痛疗效观察(1)
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[作者简介] 张陶莉(1963-)，女，本科学历，内科副主任医师，主要研究方向为老年内科。
[摘要] 目的：探讨氯吡格雷联合阿托伐他汀治疗老年不稳定性心绞痛患者的临床疗效及安全性。方法：将109例不稳定性心绞痛患者随机分为治疗组54例和对照组55例，两组均给予硝酸酯类药物、β受体阻滞剂等治疗。治疗组加氯吡格雷75 mg，每日1次口服；阿托伐他汀20 mg，睡前口服，疗程为12周。比较两组患者治疗后心绞痛症状控制情况及血脂情况。结果：治疗组总有效率为92.59%；对照组总有效率为70.90%，两组疗效比较差异有统计学意义(P<0.05)；治疗组治疗后血清三酰甘油、总胆固醇和低密度脂蛋白显著低于对照组(P<0.05)；两组均无出血等不良反应。结论：氯吡格雷联合阿托伐他汀治疗不稳定性心绞痛临床效果较好，安全，值得临床推广使用。
[关键词] 氯吡格雷；阿托伐他汀；老年不稳定性心绞痛
[中图分类号] R972+.3 [文献标识码]A[文章编号]1673-7210(2011)07(c)-087-02
Clinical observation of Clopidogrel combined with Atorvastatin on senile unstable angina
ZHANG Taoli
Beijing Geriatrics Hospital (the First Social Welfare Institute of Beijing City), Beijing 100029, China
[Abstract] Objective: To discuss the efficacy and safety of Clopidogrel combined with Atorvastatin on senile unstable angina. Methods: 109 patients with unstable angina were randomly divided into treatment group (54 cases) and control group (55 cases). Two groups were both given nitrates, β blockers and other treatment. Treatment group was given Clopidogrel oral dose of 75 mg per day and Atorvastatin 20 mg orally at bedtime daily for 12 weeks, and comparatively analyze the data of two groups. The situations of angina symptom controls and blood lipids after treatment were compared. Results: The total effective rate of treatment group was 92.59% while control group was 70.90%; the difference between two groups was statistically significant (P<0.05). After treatment, serum triglycerides, total cholesterol and LDL of treatment group were significantly lower than the control group (P<0.05). There was no bleeding and other adverse reactions in two groups. Conclusion: The clinical effect of Clopidogrel combined with Atorvastatin on unstable angina is better and safe, and it is worthy of clinical application.
[Keywords] Clopidogrel; Atorvastatin; Senile unstable angina
老年不稳定性心绞痛(UAP)多数和动脉粥样硬化斑块的破裂出血及血栓的形成有关。斑块破裂后，斑块下的胶原纤维或脂肪暴露出来，将血小板激活，从而导致血栓形成。依据其发病机制，不稳定性心绞痛在治疗上主张早期开始抗血小板和抗凝治疗[1]。而氯吡格雷是新一代的抗血小板药物，能够改变斑块的组成。他汀类药物起初作为一种降低血胆固醇的药物被应用于临床，但许多临床和基础试验证明这类药物具有降脂以外的作用[2]。笔者应用氯吡格雷联合阿托伐他汀治疗不稳定心绞痛患者，取得了满意效果，现报道如下：
1 资料与方法
1.1 一般资料 ......
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