目的 觀察替格瑞洛聯(lián)合瑞舒伐他汀治療不穩(wěn)定型心絞痛的臨床療效.方法 收集2014年1月—2015年1月北京京煤集團(tuán)總醫(yī)院心內(nèi)科收治的不穩(wěn)定型心絞痛患者106例,隨機(jī)分為對(duì)照組和治療組,每組53例.對(duì)照組在常規(guī)治療基礎(chǔ)上加用硫酸氫氯吡格雷片,首劑量300 mg/次,以后75 mg/次,1次/d;同時(shí)口服瑞舒伐他汀鈣片10 mg/次,1次/d.治療組口服替格瑞洛片,首劑量180 mg/次,以后90 mg/次,2次/d,瑞舒伐他汀鈣片的用法用量同對(duì)照組.兩組均連續(xù)治療4周.觀察治療后兩組患者的心電圖療效、臨床療效,并對(duì)兩組患者治療前后總膽固醇(TC)、三酰甘油(TG)、低密度脂蛋白膽固醇(LDL-C)、高敏C反應(yīng)蛋白(hs-CRP)、白細(xì)胞介素6(IL-6)、N末端B型鈉尿肽原(NT-proBNP)、血小板聚集率(MPA)、血小板反應(yīng)指數(shù)(PRI)進(jìn)行比較.結(jié)果 治療后,對(duì)照組和治療組心電圖療效總有效率分別為67.92%、86.79%,兩組臨床療效總有效率分別為69.81%、88.68%;兩組心電圖總有效率和臨床療效總有效率比較差異有統(tǒng)計(jì)學(xué)意義(P< 0.05).治療后,兩組患者心絞痛發(fā)作次數(shù)較治療前顯著減少,每次心絞痛持續(xù)時(shí)間均較同組治療前顯著縮短,同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P< 0.05);且治療組的改善程度優(yōu)于對(duì)照組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P< 0.05).兩組TG、TC、LDL-C、hs-CRP、IL-6、NT-proBNP、MPA均較治療前顯著降低,同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P< 0.05);且治療組這些觀察指標(biāo)的改善程度優(yōu)于對(duì)照組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P< 0.05).結(jié)論 替格瑞洛聯(lián)合瑞舒伐他汀治療不穩(wěn)定型心絞痛具有較好的臨床療效,患者癥狀改善明顯,不良反應(yīng)較輕,值得臨床推廣應(yīng)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.