目的 探究冠脉宁片联合比伐芦定治疗不稳定型心绞痛的临床疗效。方法 选取2020年1月—2022年2月在禹州市人民医院心内科治疗的200例不稳定型心绞痛患者，按照随机数字表法将所有患者分为对照组和治疗组，每组各100例。对照组患者静脉滴注注射用比伐芦定，0.25 g/次，稀释后加入0.9%氯化钠注射液250 mL，1次/d。治疗组在对照组的基础上口服冠脉宁片，5片/次，1次/d。两组用药14 d。观察两组的临床疗效，比较两组心绞痛发作频率、持续时间、血清基质金属蛋白酶-9（MMP-9）、白细胞介素-6（IL-6）、血管内皮素-1（ET-1）、C反应蛋白（CRP）和不良反应发生情况。结果 治疗后，治疗组总有效率是98.0%显著高于对照组的89.0%（P＜0.05）。经治疗，治疗组临床出现胸闷、心前区疼痛、气短、周身乏力等改善时间均显著短于对照组（P＜0.05）。治疗后，两组心绞痛发作频率、持续时间均显著降低（P＜0.05）；治疗后，治疗组心绞痛发作频率、持续时间均低于对照组（P＜0.05）。治疗后，两组MMP-9、IL-6、ET-1、CRP水平均较治疗前显著降低（P＜0.05）；治疗后，治疗组MMP-9、IL-6、ET-1、CRP水平均低于对照组（P＜0.05）。治疗组不良反应发生率是5%，显著低于对照组的11%（P＜0.05）。结论 冠脉宁片联合比伐芦定治疗不稳定型心绞痛效果明显，可有效改善患者症状，减轻心绞痛发作频率及次数，降低心肌炎性反应，且安全有效，值得临床借鉴。

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

北京医学奖励基金会课题研究项目(20210113)