2020 年第 7 期 第 15 卷

替格瑞洛联合阿托伐他汀对急性冠状动脉综合征患者高敏C反应蛋白及血脂水平的影响

Effect of ticagrelor combined with atorvastatin on hypersensitive C-reactive protein and serum lipid indexes in patients with acute coronary syndrome

作者：韩晓涛董茜陈永福宋毓青卢利红杨柳苏云娟张素娟

英文作者：Han Xiaotao Dong Qian Chen Yongfu Song Yuqing Lu Lihong Yang Liu Su Yunjuan Zhang Sujuan yndrome

单位：首都医科大学附属北京地坛医院心内科100015

英文单位：Department of Cardiology Beijing Ditan Hospital Capital Medical University Beijing 100015 China ome

关键词：急性冠状动脉综合征；替格瑞洛；阿托伐他汀；高敏C反应蛋白

英文关键词：Acutecoronarysyndrome;Ticagrelor;Atorvastatin;HypersensitiveC-reactiveprotein 

• 摘要：

• 目的探讨替格瑞洛联合阿托伐他汀对急性冠状动脉综合征（ACS）患者高敏C反应蛋白（hs-CRP）及血脂水平的影响。方法选取2018年6月至2019年3月在首都医科大学附属北京地坛医院心内科接受治疗的ACS患者111例，根据用药方案不同分为对照组（55例）和观察组（56例），常规给予阿司匹林口服（首次负荷剂量300 mg，维持剂量100 mg/次，1次/d）的基础上，观察组给予替格瑞洛（负荷剂量180 mg，维持量90 mg/次，2次/d）和阿托伐他汀（20 mg/d，1次/晚）口服，对照组给予氯吡格雷（负荷剂量600 mg，维持量75 mg/次，1次/d）和阿托伐他汀（20 mg/d，1次/晚）口服。观察2组患者治疗前、治疗24 h 及7 d后hs-CRP和治疗90 d后血脂水平的变化，并对比2组患者主要不良心血管事件及不良反应发生率。结果治疗前2组血清hs-CRP水平差异无统计学意义（P>0.05）。治疗24 h后及7 d后，观察组hs-CRP水平低于对照组［（27.0±5.9）mg/L比（28.1±6.6）mg/L、（6.2±3.6）mg/L比（7.3±3.6）mg/L］，差异均有统计学意义（均P<0.05）。治疗前2组患者血脂水平差异均无统计学意义（均P>0.05）。治疗90 d后观察组总胆固醇、三酰甘油、低密度脂蛋白胆固醇水平低于对照组，高密度脂蛋白胆固醇水平高于对照组［（3.19±0.34）mmol/L比（3.55±0.76）mmol/L、（1.05±0.36）mmol/L比（1.36±0.52）mmol/L、（1.25±0.24）mmol/L比（1.01±0.33）mmol/L、（1.79±0.39）mmol/L比（2.09±0.46）mmol/L］，差异均有统计学意义（均P<0.05）。2组患者主要不良心血管事件及不良反应发生率差异均无统计学意义（均P>0.05）。结论对于ACS患者，与阿托伐他汀联用时，替格瑞洛较氯吡格雷能更有效地抑制炎症并降低血脂，且不增加心血管不良事件和出血事件的发生率。

• ObjectiveTo investigate the effect of ticagrelor combined with atorvastatin on hypersensitive C-reactive protein(hs-CRP) and serum lipid indexes in patients with acute coronary syndrome(ACS). Methods A total of 111 patients with ACS undergoing medicine therapy in Beijing Ditan Hospital, Capital Medical University from June 2018 to March 2019 were enrolled. Besides routine therapy with oral administration of aspirin(first dose 300 mg, maintenance dose 100 mg, once daily), the observation group(56 cases) took ticagrelor(first dose 180 mg, maintenance dose 90 mg, twice daily) and atorvastatin(20 mg/d, once before bedtime); the control group(55 cases) took clopidogrel(first dose 600 mg, maintenance dose 75 mg, once daily) and atorvastatin(20 mg/d, once before bedtime). Hs-CRP and serum lipid indexes were detected before treatment and 24 h, 7 d, 90 d after treatment. Incidences of major adverse cardiovascular events and adverse reactions were observed. Results  There were no significant differences in hs-CRP and serum lipid indexes between groups before treatment(P>0.05). At 24 h and 7 d after treatment, hs-CRP levels in observation group were significantly lower than those in control group［（27.0±5.9）mg/L vs （28.1±6.6）mg/L, （6.2±3.6）mg/L vs （7.3±3.6）mg/L］(both P<0.05). At 90 d after treatment, levels of total cholesterol, triglyceride, low density lipoprotein cholesterol in observation group were lower and HDL-C was higher than those in control group［（3.19±0.34）mmol/L vs （3.55±0.76）mmol/L, （1.05±0.36）mmol/L vs （1.36±0.52）mmol/L, （1.25±0.24）mmol/L vs （1.01±0.33）mmol/L, （1.79±0.39）mmol/L vs （2.09±0.46）mmol/L］(all P<0.05). There were no significant differences in major adverse cardiovascular events and adverse reactions between groups(all P>0.05). Conclusion Ticagrelor combined with atorvastatin treating ACS is more effective in inhibiting inflammation and lowering blood lipids than clopidogrel with atorvastatin without increasing cardiovascular events and bleeding events.