阿托伐他汀联合替格瑞洛治疗不稳定型心绞痛的临床疗效观察

摘要

目的：观察阿托伐他汀联合替格瑞洛治疗不稳定型心绞痛（UAP）的临床疗效。方法选择2013年7月—2014年6月在延安市人民医院心内科门诊就诊或住院的 UAP 患者192例，根据随机数字表法分为观察组和对照组，各96例。对照组患者在常规治疗基础上给予阿托伐他汀联合氯吡格雷治疗，观察组患者在常规治疗基础上给予阿托伐他汀联合替格瑞洛治疗，两组患者均连续治疗1个月。判定两组患者临床疗效，记录患者治疗前后心绞痛发作频率及持续时间、治疗期间不良反应发生情况，比较两组患者治疗前后血脂指标〔总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（ HDL-C）〕、同型半胱氨酸（ Hcy）及氨基末端脑钠肽前体（NT-proBNP）水平。结果观察组患者临床疗效优于对照组（u ＝3.068，P ＝0.002）。治疗前两组患者心绞痛发作频率和持续时间比较，差异无统计学意义（P ﹥0.05）；治疗后观察组患者心绞痛发作频率低于对照组，心绞痛持续时间短于对照组（P ﹤0.05）。治疗前两组患者血清 TC、TG、LDL-C、HDL-C、Hcy 及NT-proBNP水平比较，差异无统计学意义（P ﹥0.05）；治疗后观察组患者血清 TC、TG、LDL-C、Hcy 及NT-proBNP水平低于对照组，血清HDL-C水平高于对照组（P ﹤0.05）。治疗期间观察组不良反应发生率为1.0%，对照组为3.1%，差异无统计学意义（P ﹥0.05）。结论阿托伐他汀联合替格瑞洛治疗 UAP 的临床疗效确切，能有效改善患者心绞痛症状、血脂，降低血清 Hcy 及NT-proBNP水平，且安全性较高。%Objective To observe the clinical effect of atorvastatin combined with ticagrelor on unstable angina pectoris. Methods A total of 192 patients with unstable angina pectoris were selected in the People's Hospital of Yan'an from July 2013 to June 2014,and they were divided into control and observation group according to random number table,each of 96 cases. Based on conventional treatment,patients of control group were given atorvastatin combined with clopidogrel,while patients of observation were given atorvastatin combined with ticagrelor;both groups treated for 1 month. Clinical effect,attack frequency and duration of angina pectoris,incidence of adverse reactions during treatment,blood lipids index(including TC, TG,LDL-C and HDL-C),Hcy and NT-proBNP levels were compared between the two groups. Results The clinical effect of observation group was statistically significantly better than that of control group( u = 3. 068,P = 0. 002). No statistically significant differences of attack frequency or duration of angina pectoris was found between the two groups before treatment(P ﹥0. 05);after treatment,attack frequency of angina pectoris of observation group was statistically significantly lower than that of control group,and duration of angina pectoris of observation group was statistically significantly shorter than that of control group (P ﹤ 0. 05). No statistically significant differences of serum level of TC,TG,LDL-C,HDL-C,Hcy or NT-proBNP was found between the two groups before treatment(P ﹥ 0. 05);after treatment,serum levels of TC,TG,LDL-C,Hcy and NT-proBNP of observation group were statistically significantly lower than those of control group,while serum HDL-C level of observation group was statistically significantly higher than that of control group( P ﹤ 0. 05). The incidence of adverse reactions during treatment of observation group was 1. 0% ,that of control group was 3. 1% ,the difference was not statistically significantly different(P ﹥ 0. 05). Conclusion Atorvastatin combined with ticagrelor has certain clinical effect in treating unstable angina pectoris,can effectively relieve the angina symptoms and blood lipid metabolism, reduce the serum levels of Hcy and NT-proBNP,and is safe.