目的 探究美托洛尔联合阿托伐他汀治疗老年不稳定心绞痛的临床疗效。方法 选择2012年4月—2014年4月总后勤部广州离职干部休养所门诊部收治的老年不稳定心绞痛患者83例，随机分为治疗组（42例）和对照组（41例）。在常规治疗基础上，对照组口服阿托伐他汀片，2片/次，2次/d。治疗组患者在对照组治疗基础上口服酒石酸美托洛尔片，1片/次，2次/d。两组均连续治疗8周。治疗后，对两组的临床疗效进行评价，同时比较两组患者心绞痛发作持续时间及发作频率。结果 治疗组和对照组总有效率分别为88.1%、68.3%，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者心绞痛发作持续时间、发作频率均明显少于治疗前，同组治疗前后差异有统计学意义（P<0.05）；治疗后治疗组这两个观察指标的改善程度优于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者的每搏输出量（SV）、射血分数（EF）均明显高于同组治疗前水平，差异有统计学意义（P<0.05）；治疗后治疗组SV、EF高于对照组，两组比较差异有统计学意义（P<0.05）。结论 美托洛尔联合阿托伐他汀治疗老年不稳定心绞痛有较好的临床疗效，可有效降低心绞痛发作持续时间和发作频率，具有一定临床应用价值。

Objective To explore the clinical efficacy of metoprolol combined with atorvastatin in treatment of elderly unstable angina. Methods Elderly patients with unstable angina (83 cases) of Clinic Department of Resthome for Retied Veterans in Guangzhou, General Logistics Department of Chinese PLA April, 2012 to April, 2014 were randomly divided into treatment (n = 42) and control (n = 41) groups. Patients in the control group were po administered with Atorvastatin Tablets on the basis of conventional treatment, 2 pieces/time, twice daily. Patients in the treatment group were po administered with Metoprolol Tartrate Tablets on the basis of control group, one piece/time, twice daily. After treatment, the treatment efficacies in two groups were evaluated, and duration time and frequency of angina attacks in two groups were compared.Results After treatment, the effective rates in the treatment and control groups were 88.1% and 68.3%, respectively, with significant difference between the two groups (P< 0.05). After treatment, duration time and frequency of angina attacks in two groups were significantly less than those before the treatment, with statistically significant difference before and after treatment in the same group (P< 0.05). Those detection indexes in the treatment group were improved better than those in the control group, with statistically significant difference (P< 0.05). After treatment, the SV and EF in two groups were significantly higher than those before the treatment, with statistically significant difference before and after treatment in the same group (P< 0.05). SV and EF in the treatment group were higher than those in the control group after treatment, with statistically significant difference (P< 0.05). Conclusion Metoprolol combined with atorvastatin has a good clinical efficacy in treatment of elderly unstable angina, and can effectively reduce the duration time and frequency of angina attacks, which has a certain clinical application value.

国家自然科学基金资助项目（81070196）