目的 探討磺達肝癸鈉與美托洛爾聯(lián)合治療老年不穩(wěn)定型心絞痛的臨床療效。方法 選擇2020年1月—2022年1月在梧州市人民醫(yī)院治療的102例心絞痛患者，根據(jù)隨機數(shù)字表法分為對照組和治療組，每組各51例。對照組口服酒石酸美托洛爾片，25 mg/次，2次/d。在對照組基礎上，治療組皮下注射磺達肝癸鈉注射液，2.5 mg/次，1次/d。兩組患者治療7 d。觀察兩組患者臨床療效，比較治療前后兩組患者癥狀改善時間、心絞痛發(fā)作次數(shù)和持續(xù)時間，血清因子C反應蛋白（CRP）、白細胞介素-18（IL-18）、腫瘤壞死因子-α（TNF-α）和白細胞介素-6（IL-6）水平。結果 治療后，治療組總有效率（98.04%）明顯高于對照組有效率（82.35%，P＜0.05）。治療后，治療組癥狀改善時間均明顯早于對照組（P＜0.05）。治療后，兩組心絞痛發(fā)作次數(shù)、持續(xù)時間較治療前均下降（P＜0.05），且治療組明顯低于對照組（P＜0.05）。治療后，兩組血清因子IL-6、IL-18、TNF-α、CRP水平較治療前均明顯降低（P＜0.05），且治療組的IL-6、IL-18、TNF-α、CRP水平均低于對照組（P＜0.05）。結論 磺達肝癸鈉聯(lián)合美托洛爾治療老年不穩(wěn)定型心絞痛效果顯著，可降低發(fā)作次數(shù)，有效降低炎性因子，且安全性高。

Objective To investigate the clinical effect of fondaparinux sodium combined with metoprolol tartrate in treatment of senile unstable angina pectoris.Methods Patients (102 cases) with angina pectoris in the People's Hospital of Wuzhou from January 2020 to January 2022 were divided into control and treatment group by random number table method,and each group had 51 cases.Patients in the control group were po administered with Metoprolol Tartrate Tablets,25 mg/time,twice daily.Patients in the treatment group were sc injection administered with Fondaparinux Sodium Injection on the basis of the control group,2.5 mg/time,once daily.Patients in two groups were treated for 7 d.After treatment,the clinical evaluation was evaluated,the improvement time of clinical symptom,the frequency and duration of angina pectoris attacks,the levels of serological IL-6,IL-18,TNF-α,and CRP,and adverse reactions in two groups before and after treatment were compared.Results After treatment,the clinical effective rate of the treatment group (98.04%) was significantly higher than that of the control group (82.35%,P<0.05).After treatment,the improvement time of symptom in the treatment group was significantly earlier than that in the control group (P<0.05).After treatment,the frequency and duration of angina pectoris in two groups were lower than those before treatment (P<0.05),and which in the treatment group were significantly lower than those in the control group (P<0.05).After treatment,the serum levels of IL-6,IL-18,TNF-α,and CRP in two groups were significantly lower than those before treatment,and which in the treatment group were significantly lower than those in the control group (P<0.05).Conclusion The effect of fondaparinux sodium combined with metoprolol tartrate in treatment of senile unstable angina pectoris is remarkable,can reduce the number of attacks,effectively reduce inflammatory factors,and the safety is high.

R972

廣西壯族自治區(qū)衛(wèi)生健康委員會自籌經(jīng)費科研課題(Z20201026)