目的 探讨替格瑞洛联合阿司匹林对高龄急性冠脉综合征（ACS）患者的近期疗效及血清指标的影响。方法 选择宝鸡市中医医院2017年1月—2018年8月收治的75例高龄ACS患者，根据随机数字表法分为观察组（38例）及对照组（37例）。对照组患者口服阿司匹林，100 mg，1次/d。观察组在对照组基础上加用替格瑞洛片，90 mg/次，2次/d。两组患者均持续治疗3个月。观察两组患者的近期疗效、不良心血管事件，比较两组治疗前后的C反应蛋白（CRP）、脑钠肽（BNP）、肌钙蛋白T（cTnT）、D-二聚体（D-D）水平及不良反应发生率。结果 治疗后，观察组的总有效率为94.7%，显著高于的对照组78.4%，两组比较差异具有统计学意义（P<0.05）。治疗后，观察组的心血管事件发生率为7.9%，明显低于对照组的21.6%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组的CRP、BNP、cTnT、D-二聚体水平均显著下降（P<0.05），且观察组显著低于对照组（P<0.05）。两组不良反应对比无统计学意义。结论 替格瑞洛联合阿司匹林对高龄ACS患者的近期疗效显著，可显著降低患者的血清指标水平，且应用安全，心血管不良事件发生率低，值得临床推广应用。

Objective To investigate the effect of ticagrelor combined with aspirin on short-term efficacy and serum index in elderly patients with ACS. Methods 75 elderly patients with ACS from January 2017 to August 2018 in Baoji Traditional Chinese Medicine Hospital were chosen and divided into the observation group (38 cases) and control group (37 cases) according to random number table method. Patients in the control group were po asministered with aspirin, 100 mg, once daily. Patients in the observation group were po asministered with Ticagrelor Tablets on the basis of control group, 90 mg/time, twice daily. Patients in two groups were treated for 3 months. After treatment, the short-term efficacy, adverse cardiovascular events were observed, and the CRP, BNP, cTnT, D-D levels before and after treatment in two groups were compared, and adverse reactions rate of two groups were compared. Results After treatment, the total efficacy rate of observation group was 94.7%, which was higher than 78.4% in the control group, and there were differences between two groups (P<0.05). After treatment, the incidence of cardiovascular events of observation group was 7.9%, which was significantly lower than 21.6% in the control group, and there were differences between two groups (P<0.05). After treatment, the levels of CRP, BNP, cTnT, and D-D in two groups were obviously decreased (P<0.05). And the levels of CRP, BNP, cTnT, and D-D in the observation group were significantly lower than those in the control group (P<0.05). The adverse reaction of two groups had no significant difference. Conclusion The short-term effect of ticagrelor combined with aspirin on elderly patients with ACS was significant, could significantly decreased the serum indexes level of patients, and the application is safe, the incidence of cardiovascular adverse events is low, which was worthy of clinical application.