目的 探讨不同剂量氯吡格雷联合阿魏酸哌嗪分散片治疗老年冠心病不稳定心绞痛的临床效果。方法 选取2015年8月—2017年8月在平煤神马医疗集团总医院就诊的老年冠心病不稳定心绞痛患者120例，按照入院先后顺序分为观察组（n=60）和对照组（n=60），两组患者均给予口服阿魏酸哌嗪分散片100 mg，3次/d，同时对照组和观察组患者分别给予氯吡格雷75 mg/d和150 mg/d。比较两组临床效果、心绞痛发作频率和持续时间、心功能指标及不良反应发生率。结果 与对照组总有效率76.67%比较，观察组总有效率91.67%显著升高（P<0.05）。治疗后两组心绞痛发作频率和持续时间均较治疗前显著减少（P<0.05）；且观察组心绞痛发作频率和持续时间显著少于对照组（P<0.05）。治疗后两组心输出量（CO）、左室射血分数（LVEF）、每搏量（SV）均较治疗前显著升高（P<0.05），左室舒张末内径（LVDD）较治疗前显著降低（P<0.05）；且观察组心功能指标（CO、LVEF、LVDD和SV）变化更为显著（P<0.05）。两组不良反应发生率（10.00% vs 8.33%）比较，差异不显著。结论 大剂量（150 mg/d）氯吡格雷联合阿魏酸哌嗪分散片可有效提高老年冠心病不稳定心绞痛的临床疗效，并改善心功能。

Objective To investigate the clinical effect of different doses of clopidogrel combined with piperazine ferulate dispersible tablets on unstable angina pectoris in elderly patients with coronary heart disease.Methods 120 elderly patients with unstable angina pectoris in our hospital from August 2015 to August 2017 were divided into observation group (n=60) and control group (n=60) according to the order of admission. Both groups were given 100 mg piperazine ferulate dispersible tablets orally, three times a day, while the control group was given clopidogrel 75 mg/d. The observation group was given clopidogrel 75 mg/d. Give clopidogrel 150 mg/d. The clinical effects of the two groups were compared.Results Compared with the control group, the total effective rate of the observation group was 91.67% significantly higher (P<0.05). After treatment, the attack frequency and duration of angina pectoris in the two groups were significantly reduced (P<0.05), and the attack frequency and duration of angina pectoris in the observation group were significantly reduced (P<0.05). After treatment, CO, LVEF and SV in both groups were significantly higher than before treatment (P<0.05), and LVDD was significantly lower than before treatment (P<0.05). Moreover, the changes of cardiac function(CO, LVEF, LVDD and SV) in the observation group were more obvious (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (10% vs 8.33%).Conclusion High dose (150 mg/d) clopidogrel combined with piperazine ferulate dispersible tablets can effectively improve the clinical efficacy of unstable angina pectoris in elderly patients with coronary heart disease and improve cardiac function.