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目的观察强化抗血小板治疗不稳定型心绞痛(UA)的疗效。方法128例UA患者在基础治疗的同时联合应用氯吡格雷和阿司匹林,首次负荷量各300 mg/d,维持量氯吡格雷75 mg/d,阿司匹林100 mg/d,观察治疗2周时UA患者心绞痛发作频率、程度、持续时间、硝酸甘油用量及18导联静息心电图ST-T改变,以ST下移导联数(NST)和ST段下移总和(∑ST)表示心肌缺血的范围和程度。每周化验血常规,观察不良反应。并继续两药合用至少1个月。结果心绞痛症状疗效:显效112例,占87.50%;有效13例,占10.16%;无效3例,占2.34%。心电图疗效:显效60例,占46.88%;有效48例,占37.50%;无效20例,占15.62%。副作用:皮疹1例、胃肠道反应3例,皮肤粘膜出血2例。结论氯吡格雷联用阿司匹林强化抗血小板治疗UA效果显著,无严重副作用,应常规应用于UA患者,尤其在不具备早期介入治疗条件的医院,更值得推广应用。
Objective To observe the effect of antiplatelet therapy on unstable angina pectoris (UA). Methods A total of 128 UA patients were treated with clopidogrel and aspirin at baseline for the first time. The initial load was 300 mg / d, while the maintenance dose of clopidogrel 75 mg / d and aspirin 100 mg / d. UA patients The frequency, extent and duration of angina pectoris, the amount of nitroglycerin and the ST-T changes of 18-lead resting electrocardiogram were used to show the range of myocardial ischemia And the degree. Weekly blood test, observe the adverse reactions. And continue the two drugs combined for at least 1 month. The results of angina symptoms and symptoms: 112 cases markedly effective, accounting for 87.50%; effective in 13 cases, accounting for 10.16%; invalid in 3 cases, accounting for 2.34%. ECG effect: markedly effective in 60 cases, accounting for 46.88%; effective in 48 cases, accounting for 37.50%; ineffective in 20 cases, accounting for 15.62%. Side effects: skin rash in 1 case, gastrointestinal tract reaction in 3 cases, skin and mucous membrane bleeding in 2 cases. Conclusions Clopidogrel plus aspirin plus antiplatelet therapy is effective and has no serious side effects. It should be routinely used in patients with UA, especially in hospitals that do not have the conditions of early intervention, and more should be popularized and applied.