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目的比较不同剂量氯吡格雷治疗不稳定型心绞痛(UPA)的临床疗效。方法选取2015年海南省临高县人民医院收治的UPA患者93例,采用随机数字表法分为对照组46例和观察组47例。两组患者均给予阿司匹林100 mg/d,同时对照组患者给予氯吡格雷75 mg/d,而观察组患者给予氯吡格雷150 mg/d。比较两组患者治疗前后血液流变学指标、最大血小板聚集率(MPAR)、心绞痛发作频率和持续时间及临床疗效。结果两组患者治疗前全血黏度、血浆黏度、红细胞聚集指数、MPAR比较,差异无统计学意义(P>0.05);观察组患者治疗后全血黏度、血浆黏度、红细胞聚集指数、MPAR低于对照组(P<0.05)。两组患者治疗前心绞痛发作频率和持续时间比较,差异无统计学意义(P>0.05);观察组患者治疗后心绞痛发作频率低于对照组,心绞痛持续时间短于对照组(P<0.05)。观察组患者临床疗效优于对照组(P<0.05)。结论与小剂量氯吡格雷(75 mg/d)相比,大剂量氯吡格雷(150 mg/d)能更有效地改善心绞痛患者血液流变学指标,降低心绞痛发作频率并缩短心绞痛发作时间,临床疗效较好。
Objective To compare the clinical effects of different doses of clopidogrel in the treatment of unstable angina pectoris (UPA). Methods Ninety-three patients with UPA admitted to Lingao County People’s Hospital of Hainan Province in 2015 were divided into control group (n = 46) and observation group (n = 47) by random number table. Both groups were given aspirin 100 mg / d, while patients in the control group were given clopidogrel 75 mg / d, whereas those in the observation group were given clopidogrel 150 mg / d. Blood rheology, MPAR, angina pectoris frequency, duration and clinical efficacy were compared between the two groups before and after treatment. Results There was no significant difference in the whole blood viscosity, plasma viscosity, erythrocyte aggregation index and MPAR between the two groups before treatment (P> 0.05). The whole blood viscosity, plasma viscosity, erythrocyte aggregation index and MPAR in the observation group were lower than Control group (P <0.05). The frequency and duration of angina pectoris before treatment in both groups had no significant difference (P> 0.05). The frequency of angina pectoris in observation group was lower than that in control group, and the duration of angina pectoris was shorter than that in control group (P <0.05). The clinical efficacy of the observation group was better than that of the control group (P <0.05). Conclusion Compared with low dose clopidogrel (75 mg / d), high dose clopidogrel (150 mg / d) is more effective in improving the hemorrheological parameters, reducing the frequency of angina pectoris and shortening angina pectoris time, Clinical efficacy is better.