目的 探寻环磷腺苷葡胺联合硫酸氢氯吡格雷治疗冠心病心绞痛的临床效果。方法 选取2024年4月—2025年4月周口市中心医院收治的100例冠心病心绞痛患者，根据治疗方式差异将患者分为对照组和治疗组，每组各50例。对照组给予硫酸氢氯吡格雷片，75 mg/次，1次/d。治疗组在对照组治疗基础上静脉滴注注射用环磷腺苷葡胺，120 mg注射用环磷腺苷葡胺加入5%葡萄糖注射液250 mL，1次/d。两组患者均连续治疗2周。对比两组临床疗效、心绞痛症状发作情况、心功能[心排血量（CO）、左心室射血分数（LVEF）与左心室舒张末期内径（LVEDD）]、血清指标[超敏C反应蛋白（hs-CRP）与血脑利钠肽前体（NT-proBNP）]。结果 治疗后，治疗组总有效率（94.00%）显著高于对照组（78.00%，P＜0.05）。治疗后，两组患者心绞痛发作频率、发作持续时间均较治疗前缩短，而发作间隔时间较治疗前延长（P＜0.05），且与对照组相比，治疗组发作频率、发作持续时间短于对照组，而发作间隔时间较对照组更长（P＜0.05）。治疗后，两组患者CO、LVEF指标均高于治疗前，而LVEDD指标低于治疗前（P＜0.05），且与对照组相比，治疗组CO、LVEF高于对照组，而LVEDD低于对照组（P＜0.05）。治疗后，两组患者hs-CRP、NT-proBNP水平均低于治疗前（P＜0.05），且与对照组相比，治疗组血清hs-CRP、NT-proBNP低于对照组（P＜0.05）。结论 环磷腺苷葡胺与硫酸氢氯吡格雷联合疗法可显著改善冠心病心绞痛患者的心功能指标与炎症状态，有效减少其心绞痛发作，最终实现临床疗效的整体提升。

Objective To explore the effect of meglumine adenosine cyclophosphate combined with clopidogrel bisulfate in treatment of angina pectoris of coronary heart disease. Methods A total of 100 patients with angina pectoris of coronary heart disease who were admitted to Zhoukou Central Hospital from April 2024 to April 2025 were selected. According to the differences in treatment methods, the patients were divided into control group and treatment group, with 50 cases in each group. Patients in control group were given Clopidogrel Bisulfate Tablets, 75 mg each time, once daily. Patients in treatment group received intravenous infusion of Meglumine Adenosine Cyclophosphate for injection, 120 mg added to 250 mL of 5% glucose injection, once daily. Both groups of patients were treated continuously for 2 weeks. The clinical efficacy, symptoms of angina pectoris, cardiac function[cardiac output (CO), left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD)], and serum indicators[high-sensitivity C-reactive protein (hs-CRP) and brain natriuretic peptide precursor (NT-proBNP)] were compared between the two groups. Results After treatment, the total effective rate of the treatment group (94.00%) was significantly higher than that of the control group (78.00%, P < 0.05). After treatment, the frequency and duration of angina pectoris attacks in both groups were shorter compared to before treatment, while the attack interval was longer (P < 0.05). Compared with control group, the frequency and duration of attacks in treatment group were shorter, while the attack interval was longer (P < 0.05). After treatment, the CO and LVEF indicators of both groups were higher than those before treatment, while the LVEDD indicator was lower than before treatment (P < 0.05). Compared with control group, the CO and LVEF of treatment group were higher, while LVEDD was lower (P < 0.05). After treatment, the levels of hs-CRP and NT-proBNP in both groups were lower than those before treatment (P < 0.05), and compared with control group, the serum hs-CRP and NT-proBNP levels in treatment group were lower (P < 0.05). Conclusion The combined therapy of meglumine adenosine cyclophosphate combined with clopidogrel bisulfate can significantly improve the cardiac function indicators and inflammatory status of patients with angina pectoris of coronary heart disease, and can effectively reduce the occurrence of angina pectoris, and ultimately achieve an overall improvement in clinical efficacy.

R972

河南省医学科技攻关计划项目（LHG]20241001）