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目的:观察曲美他嗪(trimetazidine,TMZ)联合氯吡格雷(clopidogrel,CPG)治疗不稳定型心绞痛(UPA)患者的临床疗效。方法:选择UAP患者76例,随机分为两组:对照组(38例)给予阿司匹林、利尿剂、血管扩张剂、血管紧张素转换酶抑制剂(ACEI)或β受体阻滞剂等常规药物;TMZ联合CPG组(38例)在常规药物治疗基础上加用TMZ(20mgtid×56d)、氯吡格雷(首次300mg,75mg/日×55d治疗。结果:治疗后与治疗前相比,TMZ联合CPG组心绞痛改善的临床显效率(52.6%)和总有效率(87%)均较对照组(26.3%和57.9%)显著提高(P<0.01),心绞痛发作频率持续时间显著减少(p<0.01),TMZ联合CPG组心率、血压、左室射血分数、左室舒张末期容积、左室收缩末期容积均有显著改善(P<0.01或P<0.05),运动耐量(NYHA分级)明显改善,TMZ联合CPG组与对照组比较差异有显著性意义(P<0.01或P<0.05),未观察药物不良反应。结论:用TMZ联合CPG治疗UAP是一种安全有效的方法。
Objective: To observe the clinical efficacy of trimetazidine (TMZ) and clopidogrel (CPG) in patients with unstable angina pectoris (UPA). Methods: A total of 76 UAP patients were randomly divided into two groups: the control group (38 patients) were given conventional drugs such as aspirin, diuretic, vasodilator, angiotensin converting enzyme inhibitor (ACEI) or β blockers ; TMZ combined with CPG group (38 cases) added TMZ (20mgtid × 56d) and clopidogrel (first 300mg, 75mg / day × 55d) on the basis of conventional drug treatment.Results: Compared with before treatment, TMZ combined The clinical effective rate (52.6%) and total effective rate (87%) in patients with CPG improved significantly (P <0.01) and the duration of angina pectoris frequency significantly decreased (P <0.01) compared with control group (26.3% and 57.9% ), Heart rate, blood pressure, left ventricular ejection fraction, left ventricular end-diastolic volume and left ventricular end-systolic volume in TMZ combined with CPG group were significantly improved (P 0.01 or P 0.05), exercise tolerance (NYHA classification) TMZ combined with CPG group and control group had significant difference (P <0.01 or P <0.05), no adverse reactions were observed.Conclusion: TMZ combined with CPG treatment of UAP is a safe and effective method.