目的:探讨替格瑞洛联合强化阿托伐他汀治疗在非ST抬高型急性冠脉综合征(NSTE-ACS)中的安全性与有效性.方法:NSTE-ACS患者80例,均行经皮冠状动脉介入(PCI)治疗,将所有患者随机分为观察组和对照组,各40例.观察组给予替格瑞洛90 mg,2次/d及阿托伐他汀钙片40 mg,1次/晚;对照组给予硫酸氢氯吡格雷75 mg,1次/d及阿托伐他汀钙片20 mg,1次/晚.比较两组患者PCI术前、术后1个月、3个月血清肌酐(CR)、尿素氮(UN)、肌酸激酶(CK)、肌红蛋白(MB)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)的变化情况及术后3个月不良临床事件发生情况.结果:两组患者PCI术前CR、UN、CK、MB、ALT、AST比较,差异无统计学意义;PCI术后1个月,观察组的CR、ALT高于对照组(P＜0.05),其他实验室指标两组差异无统计学意义.术后3个月时,两组的实验室指标差异无统计学意义;术后3个月对照组1例患者死亡,死因为心源性休克.观察组不良临床事件发生率为5％,低于对照组的25％(P＜0.05).结论:在行PCI治疗的NSTE-ACS患者中,替格瑞洛联合强化他汀类治疗与氯吡格雷联合常规剂量他汀治疗相比,未增加明显药物不良反应,且降低了患者PCI术后不良事件发生率.%Obiective:To investigate the safety and efficacy of ticagrelor combined with intensive atorvastatin in the treatment of non-ST elevation acute coronary syndrome (NSTE-ACS).Methods:NSTE-ACS patients(80 cases) were treated by percutaneous coronary intervention (PCI).All patients were randomly divided into two groups:the observation group and the control group,each of 40 cases.Patients in the observation group were given ticagrelor 90mg twice daily and atorvastatin 40 mg daily.The control group was given clopidogrel 75 mg daily and atorvastatin 20 mg daily.Serum creatinine (CR),blood urea nitrogen (UN),creatine kinase (CK),myoglobin (MB),alanine aminotransferase (ALT) and aspartic transaminase(AST) before PCI and 1 month and 3 months after PCI,and the incidence of adverse clinical events at 3 months postoperatively were compared between the two groups.Results:There was no significant difference in CR,UN,CK,MB,ALT and AST between the two groups before PCI (P＞ 0.05).The CR and ALT of the observation group were higher (P＜0.05).There was no significant difference between the two groups in other laboratory indexes (P＞0.05).At 3 months after operation,there was no significant difference between the two groups (P＞0.05).One patient died caused by cardiogenic shock in the control group at 3 months after operation.The incidence of adverse events of the observation group was 5％,was lower than in the control group 0f 25 ％.Conclusions:In patients with NSTE-ACS,ticagrelor combined with intensive atorvastatin therapy did not increase the adverse drug reaction and decrease the incidence of adverse events after PCI compared with conventional-dose atorvastatin and clopidogrel therapy.
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