替格瑞洛联合强化阿托伐他汀治疗NSTE-ACS  

Efficacy of Tigrelol combined with intensive atorvastatin in the treatment of non-ST-segment elevation acute coronary syndrome

作　　者：陆子华 傅娟 Lu zihua;Fu juan(Affiliated Hospital of Jiangxi Jiujiang University,Jiujiang,332000,China)

机构地区：[1]九江学院附属医院,332000

出　　处：《临床心电学杂志》2023年第4期278-282,287,共6页Journal of Clinical Electrocardiology

摘　　要：目的 探究替格瑞洛与强化阿托伐他汀联合用药治疗非ST段抬高型急性冠脉综合征(NSTE-ACS)的疗效及对血清γ-谷氨酰基转移酶(GGT)、冠状动脉病变SYNTAX-Ⅱ评分和血管内皮功能的影响。方法 选取九江学院附属医院心内科2019年6月至2021年3月收治的年龄30~85岁的NSTE-ACS患者100例,按照随机数字表法分为联用组(n=50,替格瑞洛与强化阿托伐他汀联合用药)和常规组(n=50,氯吡格雷与常规剂量阿托伐他汀联合用药)。比较两组治疗NSTE-ACS的整体有效率及治疗前后血清GGT指标、SYNTAX-Ⅱ评分、肱动脉静息状态内径、血管内皮依赖性舒张功能(FMD)、非依赖性血管内皮舒张功能(NMD)和峰值血流变化率的变化情况。结果 联用组治疗有效率(47/50,94.0%)高于常规组(42/50,84.0%),差异具有统计学意义(P<0.05);两组治疗1月血清GGT水平均比治疗前低,联用组治疗1月、治疗3月的血清GGT水平[(35.32±3.07)U/L、(29.70±5.15)U/L]明显低于常规组[(49.41±2.15)U/L、(33.69±4.13)U/L],差异具有统计学意义(P<0.05);两组治疗前SYNTAX-Ⅱ评分无统计学差异(P>0.05),两组治疗后SYNTAX-Ⅱ评分均降低,且联用组治疗3月[(19.37±3.21)分]低于常规组[(22.15±3.46)分],差异具有统计学意义(P<0.05);两组患者肱动脉静息状态内径和NMD在治疗前后不存在统计学差异(P>0.05),两组FMD和峰值血流变化率在联合用药治疗后都比治疗前有所上升,联用组治疗后FMD[(6.25±1.06)%]、峰值血流变化率[(52.76±5.14)%]上升幅度高于常规组FMD[(5.54±1.08)%、(47.26±3.51)%],差异具有统计学意义(P<0.05)。结论 对NSTE-ACS患者使用替格瑞洛联合强化阿托伐他汀的治疗效果比常规用药好,血管内皮功能明显改善,可以有效降低血清GGT水平及SYNTAX-Ⅱ评分且更能抑制冠状动脉病变。Objective To explore the efficacy of ticagrelor combined with intensive atorvastatin in the treatment of non-ST-segment elevation acutecoronary syndrome(NSTE-ACS)and its influence on serum gamma-glutamyltransferase(GGT),coronary artery disease SYNTAX-II score judgment and vascular endothelial function.Methods A total of 100 patients with NSTE-ACS aged 30~85 years treated in Department of Cardiology of our hospital were selected from June 2019 and March 2021,and were divided into a combined group(n=50),ticagrelor combined with intensive atorvastatin and a conventional group(n=50),combination of clopidogrel and conventional dose of atorvastatin according to the random number table method.The overall effective rate of NSTE-ACS,as well as changes in serum GCT,SYNTAX-II score,inner diameter of brachial artery at resting state,flow-mediated dilation(FMD),nitroglycerin-mediated dilation(NMD)and change rate of peak blood flow before and after treatment were compared between the two groups.Results The treatment effective rate of the combined group was higher than that of the conventional group[94.0%(47/50)vs 84.0%(42/50)(P<0.05].After 1 month of treatment,serum GGT levels in the two groups were lower than those before treatment.The levels of serum GGT with(35.32±3.07)U/L and(29.70±5.15)U/L in combined group after 1 month and 3 months of treatment were significantly lower than(49.41±2.15)U/L and(33.69±4.13)U/L in the conventional group(P<0.05).There was no significant difference in SYNTAX-II score between the combined group and the conventional group before treatment(P>0.05).The SYNTAX-II scores of the two groups were decreased afer treatment,and the score with(19.37±3.21)points afer 3 months of treatment in the combined group were lower than(22.15±3.46)points in the conventional group(P<0.05).There were no significant differences between the two groups of patients in terms of inner diameter of brachial artery at resting state and NMD before and afer treatment(P>0.05),and the FMD and change rate of peak blood flow af

关 键 词：替格瑞洛 强化阿托伐他汀 非ST段抬高型急性冠脉综合征 血清γ-谷氨酰基转移酶 SYNTAX-Ⅱ评分 血管内皮功能 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]