目的 对比不同剂量替格瑞洛联合美托洛尔缓释片治疗老年冠心病不稳定心绞痛的效果。方法 2016年1月—2018年3月选择在宝鸡市中心医院诊治的老年冠心病不稳定心绞痛患者136例，根据治疗方法的不同分为观察组80例与对照组56例。对照组给予口服美托洛尔缓释片+大剂量替格瑞洛治疗，观察组给予口服美托洛尔缓释片+小剂量替格瑞洛治疗，两组都用药观察4周。比较两组临床疗效、心功能、炎症因子水平及预后情况。结果 治疗后观察组与对照组的总有效率分别为96.3%和96.4%，两组对比差异无统计学意义。两组治疗后的左心室射血分数（LVEF）值高于治疗前，左心室舒张末期半径（LVEDD）值低于治疗前，对比差异都有统计学意义（P<0.05），组间对比差异无统计学意义。两组治疗后的血清白介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）都低于治疗前，差异有统计学意义（P<0.05）；且观察组也都显著低于对照组，差异有统计学意义（P<0.05）。随访6个月，观察组的再发心绞痛、心肌梗死、冠脉再狭窄、心力衰竭等并发症发生率（3.8%）显著低于对照组（19.6%），差异有统计学意义（P<0.05）。结论 小剂量替格瑞洛联合美托洛尔缓释片治疗老年冠心病不稳定心绞痛也能改善患者的心功能，提高治疗效果，且能更加有效抑制炎症因子的释放，降低远期并发症的发生。
Objective To compare the effects of different doses of ticagrelor combined with metoprolol sustained-release tablets in the treatment of unstable angina pectoris in elderly patients with coronary heart disease. Methods From January 2016 to March 2018, 136 elderly patients of coronary heart disease with unstable angina pectoris who were diagnosed and treated in a certain hospital were selected and were divided into the 80 patients in the observation group and 56 patients in the control group accorded to different treatment methods. The control group were given metoprolol sustained-release tablets+ high-dose ticagrelor treatment, the observation group were given metoprolol sustained-release tablets+ low-dose ticagrelor treatment, the two groups were observed for 4 weeks, the prognosis of the recorded and followed-up. Results The total effective rates of the observation group and the control group after treatment were 96.3% and 96.4%, respectively, there were no significant difference compared between the two groups. The LVEF values of the two groups after treatment were higher than those before treatment, and the LVEDD values were lower than those before treatment (P<0.05), there were no significant difference compared between the two groups. The serum IL-6 and TNF- α levels in the two groups after treatment were lower than those before treatment (P<0.05), and the observation group were also significantly lower than the control group (P<0.05). After 6 months of followed-up, the incidence of complications such as recurrent angina pectoris, myocardial infarction, coronary restenosis, and heart failure in the observation group (3.8%) were significantly lower than that in the control group (19.6%) (P<0.05). Conclusion Compares to the large doses, low-dose ticagrelor combined with metoprolol sustained-release tablets in the treatment of unstable coronary heart disease in elderly patients can improve the heart function, improve the therapeutic effect, and more effectively inhibit the release of inflammatory factors, it can reduce the occurrence of long-term complications.