目的 比較比索洛爾和低分子肝素治療老年不穩(wěn)定心絞痛的臨床療效和安全性。方法 選取2011年9月-2013年4月在延安市中醫(yī)醫(yī)院就診的不穩(wěn)定心絞痛患者186例，隨機(jī)分為比索洛爾組、低分子肝素組和對照組，每組62例。對照組給予吸氧、阿司匹林、硝酸甘油治療，比索洛爾組在對照組的基礎(chǔ)上口服比索洛爾片，5 mg/次，1次/d；低分子肝素組在對照組的基礎(chǔ)上加用低分子肝素注射液，皮下注射，0.6 mL/次，2次/d。3組均連續(xù)治療2個月。治療后，比較3組患者的臨床療效和心血管事件發(fā)生率。結(jié)果 比索洛爾組、低分子肝素組的臨床療效有效率及心電圖改善優(yōu)良率均較對照組高，均具有統(tǒng)計學(xué)意義（P<0.05）；比索洛爾組的臨床療效有效率和心電圖改善優(yōu)良率均高于低分子肝素組，兩組比較差異均有統(tǒng)計學(xué)意義（P<0.05）。比索洛爾組、低分子肝素組的心絞痛、心律失常、急性心肌梗死發(fā)生率均低于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）；比索洛爾組和低分子肝素組心絞痛、心律失常、急性心肌梗死的發(fā)生率差異沒有統(tǒng)計學(xué)意義。3組不良反應(yīng)發(fā)生率比較，差異均不具有統(tǒng)計學(xué)意義。結(jié)論 在常規(guī)治療基礎(chǔ)上給予比索洛爾治療不穩(wěn)定心絞痛具有確切的臨床療效，不良反應(yīng)較少，值得臨床推廣應(yīng)用。

Objective To compare the clinical efficacy and safety between bisoprolol and low molecular heparin in the treatment of elderly unstable angina. Methods Unstable angina patients (186 cases) who came to Hospital of Traditional Chinese Medicine in Yan'an City from September 2011 to April 2013 were randomly divided into bisoprolol, low molecular heparin, and control groups, and each group had 62 cases. The patients in the treatment group were given oxygen, aspirin, and nitroglycerin. The patients in the bisoprolol group were po administered with Bisoprolol Tablets, 5 mg/time, once daily on the basis of the control group. The patients in the low molecular heparin group weresc administered with Low Molecular Heparin Injecion, 0.6 mL/time, twice daily, and other treatment was the same as the control group. The patients in three groups were treated for two months. After treatment, the clinical efficacy and incidence of cardiovascular events were compared in the three groups. Results The clinical effect and electrocardiogram improved rate in bisoprolol and low molecular heparin groups were higher than those in the control group with the significant difference (P < 0.05). The clinical effect and electrocardiogram improved rate in bisoprolol group were higher than those in the low molecular heparin group, with significant difference between the two groups (P < 0.05). The incidence of angina pectoris, arrhythmia, and acute myocardial infarction in bisoprolol and low molecular heparin groups were lower than those in the control group with the significant difference (P < 0.05). There was no significant difference between bisoprolol and low molecular heparin groups in the incidence of angina pectoris, arrhythmia, and acute myocardial infarction. Incidence of adverse reactions had no statistically significant differences in three groups. Conclusion Bisoprolol on the basis of conventional treatment has a good clinical efficacy in the treatment of unstable angina with exact clinical curative effect and less adverse reaction, which is worthy of clinical popularization and application.