目的 探究冠脈寧片聯(lián)合比伐蘆定治療不穩(wěn)定型心絞痛的臨床療效。方法 選取2020年1月—2022年2月在禹州市人民醫(yī)院心內(nèi)科治療的200例不穩(wěn)定型心絞痛患者，按照隨機(jī)數(shù)字表法將所有患者分為對照組和治療組，每組各100例。對照組患者靜脈滴注注射用比伐蘆定，0.25 g/次，稀釋后加入0.9%氯化鈉注射液250 mL，1次/d。治療組在對照組的基礎(chǔ)上口服冠脈寧片，5片/次，1次/d。兩組用藥14 d。觀察兩組的臨床療效，比較兩組心絞痛發(fā)作頻率、持續(xù)時間、血清基質(zhì)金屬蛋白酶-9（MMP-9）、白細(xì)胞介素-6（IL-6）、血管內(nèi)皮素-1（ET-1）、C反應(yīng)蛋白（CRP）和不良反應(yīng)發(fā)生情況。結(jié)果 治療后，治療組總有效率是98.0%顯著高于對照組的89.0%（P＜0.05）。經(jīng)治療，治療組臨床出現(xiàn)胸悶、心前區(qū)疼痛、氣短、周身乏力等改善時間均顯著短于對照組（P＜0.05）。治療后，兩組心絞痛發(fā)作頻率、持續(xù)時間均顯著降低（P＜0.05）；治療后，治療組心絞痛發(fā)作頻率、持續(xù)時間均低于對照組（P＜0.05）。治療后，兩組MMP-9、IL-6、ET-1、CRP水平均較治療前顯著降低（P＜0.05）；治療后，治療組MMP-9、IL-6、ET-1、CRP水平均低于對照組（P＜0.05）。治療組不良反應(yīng)發(fā)生率是5%，顯著低于對照組的11%（P＜0.05）。結(jié)論 冠脈寧片聯(lián)合比伐蘆定治療不穩(wěn)定型心絞痛效果明顯，可有效改善患者癥狀，減輕心絞痛發(fā)作頻率及次數(shù)，降低心肌炎性反應(yīng)，且安全有效，值得臨床借鑒。

Objective To investigate the efficacy of Guanmaining Tablets combined with bivalirudin in treatment of unstable angina pectoris. Methods A total of 200 patients with unstable angina pectoris treated in the Cardiology Department of Yuzhou People's Hospital from January 2020 to February 2022 were selected, and all patients were divided into control group and treatment group according to random number table method, with 100 cases in each group. Patients in the control group were iv administered with Bivalirudin for injection, 0.25 g/time, diluted and added 0.9% sodium chloride injection 250 mL, once daily. Patients in the treatment group were po administered with Guanmaining Tablets on the basis of the control group, 5 tablets/time, once daily. Both groups were treated for 14 d. The clinical efficacy of the two groups were observed, and the frequency and duration of angina pectoris attack, serum matrix metalloproteinase-9 (MMP-9), interleukin-6 (IL-6), endothelin-1 (ET-1), C-reactive protein (CRP), and incidence of adverse reactions were compared between the two groups. Results After treatment, the total effective rate in the treatment group was 98.0%, significantly higher than that in the control group (89.0%, P < 0.05). After treatment, the improvement time of chest tightness, precardiac pain, shortness of breath, and weakness of body in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the frequency and duration of angina pectoris in both groups were significantly decreased (P < 0.05). After treatment, the frequency and duration of angina pectoris in the treatment group were lower than those in the control group (P < 0.05). After treatment, the levels of MMP-9, IL-6, ET-1, and CRP in two groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the levels of MMP-9, IL-6, ET-1, and CRP in the treatment group were lower than those in the control group (P < 0.05). The incidence of adverse reactions in treatment group was 5%, significantly lower than that in control group (11%, P < 0.05).Conclusion Guanmaining Tablets combined with bivalirudin has obvious effects in treatment of unstable angina pectoris, and can effectively improve the symptoms of patients, reduce the frequency and duration of angina pectoris attack, reduce the myocardial inflammatory response, and is safe and effective, which is worthy of clinical reference.

R972

北京醫(yī)學(xué)獎勵基金會課題研究項(xiàng)目(20210113)