目的 探討替格瑞洛聯(lián)合瑞舒伐他汀對急性ST抬高心肌梗死患者心功能和血清學指標的影響。方法 選擇2018年1月—2019年5月選擇在寶雞市中醫(yī)醫(yī)院診治的急性ST段抬高型心肌梗死患者150例作為研究對象，根據(jù)隨機數(shù)字表法將患者分為對照組和觀察組，每組各75例。對照組患者在經(jīng)皮冠狀動脈介入治療（PCI）術(shù)前7 d和術(shù)后口服瑞舒伐他汀鈣片，10 mg/d。觀察組在對照組治療的基礎(chǔ)上口服替格瑞洛片，90 mg/次，1次/d。兩組均治療觀察3個月。比較兩組患者治療前后的6 min步行距離（6 MWT）、左室舒張末期內(nèi)徑（LVEDD）、左室收縮末期內(nèi)經(jīng)（LVESD）、左室間隔厚度（LVIVS）、左心室后壁厚度（LVPWT）、N末端腦鈉肽原（NT-proBNP）和超敏C反應(yīng)蛋白（hs-CRP）水平和主要心血管事件（MACE）發(fā)生情況。結(jié)果 兩組治療后的6 MWT值都顯著高于治療前（P<0.05），且觀察組高于對照組（P<0.05）。兩組治療前后的LVEDD、LVESD、LVIV、LVPWT對比無統(tǒng)計學意義。兩組治療后的血清NT-proBNP、hs-CRP水平都顯著低于治療前（P<0.05），且觀察組低于對照組（P<0.05）。觀察組治療期間的MACE發(fā)生率為5.3%，顯著低于對照組的18.7%（P<0.05）。結(jié)論 替格瑞洛聯(lián)合瑞舒伐他汀治療急性ST抬高心肌梗死能抑制NT-proBNP、hs-CRP的釋放，提高患者的6 MWT值，減少MACE的發(fā)生。

Objective To investigate the effect of ticagrelor combined with rosuvastatin on cardiac function and serological indicators in patients with acute ST elevation myocardial infarction. Methods Patients (150 cases) with acute ST-segment elevation myocardial infarction in the Baoji Traditional Chinese Medicine Hospital from January 2018 to May 2019 were selected as study subjects. According to the random number table method, the patients were divided into control group and observation group, with 75 patients in each group. Patients in the control group were po administered with Rosuvastatin Calcium Tablets at 7 days before and after PCI, 10 mg/d. Patients in the observation group were po administered with Ticagrelor Tablets on the basis of control group, 90 mg/time, and once daily. Both groups were treated and observed for 3 months. The 6 MWT, LVEDD, LVESD, LVIVS, LVPWT, and the levels of NT-proBNP and hs-CRP in two groups before and after treatment were compared, and the occurrence of major cardiovascular events (MACE) between two groups were also compared. Results After treatment, the value of 6 MWT in two groups was significantly higher than that before treatment (P<0.05), and the observation group was higher than that in the control group (P<0.05). LVEDD, LVESD, LVIV and LVPWT in two groups before and after treatment showed no statistical significance. After treatment, the serum levels of NT-proBNP and hs-CRP in two groups were significantly lower than those before treatment (P<0.05), and the observation group was lower than those in the control group (P<0.05). During the treatment, the incidence of MACE in the observation group was 5.3%, which was significantly lower than 18.7% in the control group (P<0.05).Conclusion Ticagrelor combined with rosuvastatin in treatment of acute ST-elevation myocardial infarction can inhibit the release of NT-proBNP and hsCRP, improve the 6 MWT value of patients, and reduce the occurrence of MACE.

R972

陜西省中醫(yī)管理局中醫(yī)藥科研項目（LCMS007）