目的 观察替格瑞洛联合瑞舒伐他汀治疗不稳定型心绞痛的临床疗效.方法 收集2014年1月—2015年1月北京京煤集团总医院心内科收治的不稳定型心绞痛患者106例,随机分为对照组和治疗组,每组53例.对照组在常规治疗基础上加用硫酸氢氯吡格雷片,首剂量300 mg/次,以后75 mg/次,1次/d;同时口服瑞舒伐他汀钙片10 mg/次,1次/d.治疗组口服替格瑞洛片,首剂量180 mg/次,以后90 mg/次,2次/d,瑞舒伐他汀钙片的用法用量同对照组.两组均连续治疗4周.观察治疗后两组患者的心电图疗效、临床疗效,并对两组患者治疗前后总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)、N末端B型钠尿肽原(NT-proBNP)、血小板聚集率(MPA)、血小板反应指数(PRI)进行比较.结果 治疗后,对照组和治疗组心电图疗效总有效率分别为67.92%、86.79%,两组临床疗效总有效率分别为69.81%、88.68%;两组心电图总有效率和临床疗效总有效率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次数较治疗前显著减少,每次心绞痛持续时间均较同组治疗前显著缩短,同组治疗前后差异有统计学意义(P< 0.05);且治疗组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).两组TG、TC、LDL-C、hs-CRP、IL-6、NT-proBNP、MPA均较治疗前显著降低,同组治疗前后差异有统计学意义(P< 0.05);且治疗组这些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).结论 替格瑞洛联合瑞舒伐他汀治疗不稳定型心绞痛具有较好的临床疗效,患者症状改善明显,不良反应较轻,值得临床推广应用.

Objective To observe the clinical curative effect of ticagrelor combined with rosuvastatin in treatment of unstable angina. Methods Patients (106 cases) with unstable angina of Beijing Jingmei Group General Hospital from January 2014 to January 2015, were randomly divided into control and treatment groups, and each group had 53 cases. The patients in the control group were po administered with Clopidogrel Hydrogen Sulphate Tablets, and the first dosage was 300 mg/time, then 75 mg/time, once daily. At the same time, they were po administered with Rosuvastatin Calcium Tablets, 10 mg/time, once daily. The patients in the treatment group were po administered with Ticagrelor Tablets, and the first dosage was 180 mg/time, then 90 mg/time, twice daily, and the usage and dosage of Rosuvastatin Calcium Tablets were the same as the control group. Two groups were treated for four weeks. The electrocardiogram efficacy and clinical efficacy between the two groups were observed after treatment. At the same time, TC, TG, LDL-C, hs-CRP, IL-6, NT-proBNP, MPA, and PRI in two groups were compared. Results After treatment, the electrocardiogram efficacy of control and treatment groups were 67.92% and 86.79% respectively, while symptom efficacy of two groups were 69.81% and 88.68%, respectively, and there were differences between two groups (P <0.05). Attack frequency of unstable angina in two was significantly reduced, and the duration of angina was significantly shortened, and the difference was statistically significant in the same group (P <0.05). The indicators in treatment group improved better than those in control group, with the significant difference between two groups (P <0.05). TG, TC, LDL-C, hs-CRP, IL-6, NT-proBNP, and MPA in two groups were reduced, and the difference was statistically significant in the same group (P< 0.05). The indicators in treatment group improved better than those in control group, with the significant differences between two groups (P <0.05). Conclusion Ticagrelor combined with rosuvastatin has good clinical effect in treatment of unstable angina, and symptoms of patients improve obviously with less adverse reaction, which is worth clinical promotion.