目的 探讨磺达肝癸钠与美托洛尔联合治疗老年不稳定型心绞痛的临床疗效。方法 选择2020年1月—2022年1月在梧州市人民医院治疗的102例心绞痛患者，根据随机数字表法分为对照组和治疗组，每组各51例。对照组口服酒石酸美托洛尔片，25 mg/次，2次/d。在对照组基础上，治疗组皮下注射磺达肝癸钠注射液，2.5 mg/次，1次/d。两组患者治疗7 d。观察两组患者临床疗效，比较治疗前后两组患者症状改善时间、心绞痛发作次数和持续时间，血清因子C反应蛋白（CRP）、白细胞介素-18（IL-18）、肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）水平。结果 治疗后，治疗组总有效率（98.04%）明显高于对照组有效率（82.35%，P＜0.05）。治疗后，治疗组症状改善时间均明显早于对照组（P＜0.05）。治疗后，两组心绞痛发作次数、持续时间较治疗前均下降（P＜0.05），且治疗组明显低于对照组（P＜0.05）。治疗后，两组血清因子IL-6、IL-18、TNF-α、CRP水平较治疗前均明显降低（P＜0.05），且治疗组的IL-6、IL-18、TNF-α、CRP水平均低于对照组（P＜0.05）。结论 磺达肝癸钠联合美托洛尔治疗老年不稳定型心绞痛效果显著，可降低发作次数，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

广西壮族自治区卫生健康委员会自筹经费科研课题(Z20201026)