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目的对比观察低分子肝素钙联合阿司匹林及急诊经皮腔内冠状动脉成形术(PTCA)治疗不稳定型心绞痛的疗效。方法对2001年1月至2003年9月我科收治的120例不稳定型心绞痛患者,在常规治疗基础上采用抗凝及急诊PTCA治疗并随机分为抗凝治疗组和急诊PTCA治疗组,两组患者临床特征无明显差异。前者加用低分子肝素钙(5000U)皮下注射及阿司匹林口服,后者在冠脉造影后行急诊PTCA术,观察心绞痛缓解程度(常规心电图STT改变及不良反应发生率)。结果抗凝治疗组总有效率76%,心电图改善率60%,再发心肌梗死率36%,急诊PTCA治疗组总有效率916%,心电图改善率89%,再发心肌梗死率为0;两组比较差异有显著意义(P<001)。结论急诊PTCA治疗组较抗凝治疗组对不稳定型心绞痛更加安全有效。
Objective To compare the efficacy of low molecular weight heparin with aspirin and emergency percutaneous transluminal coronary angioplasty (PTCA) in the treatment of unstable angina pectoris. Methods From January 2001 to September 2003, 120 patients with unstable angina pectoris admitted to our department were treated with anticoagulation and emergency PTCA on the basis of routine treatment and were randomly divided into anticoagulant group and emergency PTCA group. There was no significant difference in the clinical features between the two groups. The former with low molecular weight heparin (5000U) subcutaneous injection and aspirin orally, the latter underwent emergency PTCA surgery after coronary angiography to observe the extent of angina pectoris (conventional ECG STT changes and the incidence of adverse reactions). Results The total effective rate of anticoagulant therapy group was 76%, electrocardiogram improvement rate was 60%, myocardial infarction recurrence rate was 36%, emergency PTCA treatment group total effective rate was 916%, electrocardiogram improvement rate was 89%, recurrent myocardial infarction rate was 0; Group differences were significant (P <001). Conclusion The emergency PTCA group is more safe and effective than the anticoagulant group in treating unstable angina pectoris.