目的 探討芪參益氣滴丸聯(lián)合注射用重組鏈激酶治療急性心肌梗死的臨床療效。方法 選取2019年10月—2020年11月在天津市第四中心醫(yī)院就診的80例急性心肌梗死患者，根據(jù)隨機數(shù)字表法將80例患者分為對照組（40例）和治療組（40例）。對照組給予注射用重組鏈激酶，200萬UI加入20 mL生理鹽水中靜推，300萬UI加入100 mL生理鹽水中靜點，臨時1次。治療組在對照組治療的基礎上口服芪參益氣滴丸，0.5 g/次，3次/d，連續(xù)治療4周。觀察兩組的臨床療效，比較兩組治療前后心肌梗死面積、心功能指標和血清因子水平。結(jié)果 治療后，治療組的總有效率為95.00%，對照組總有效率為77.50%，組間對比有明顯差異（P<0.05）。治療后，兩組的心肌梗死面積明顯減少（P<0.05），且治療組心肌梗死面積明顯小于對照組（P<0.05）。兩組治療后的C反應蛋白（CRP）、白細胞介素-6（IL-6）、N末端B型利鈉肽原（NT-proBNP）水平明顯低于治療前（P<0.05）；治療組的CRP、IL-6、NT-proBNP比對照組低（P<0.05）。治療后，兩組的左室質(zhì)量指數(shù)（LVMI）、左室射血分數(shù)（LVEF）、左房室瓣E峰和A峰最大流速比值（E/A）均明顯升高，室間隔舒張末期厚度（IVST）明顯降低（P<0.05）；治療后，治療組患者的LVMI、LVEF、E/A高于對照組，IVST低于對照組（P<0.05）。結(jié)論 芪參益氣滴丸聯(lián)合注射用重組鏈激酶可提高急性心肌梗死的療效，縮小心肌梗死面積，改善心功能，降低炎癥因子。

Objective To investigate the clinical efficacy of Qishen Yiqi Dropping Pills combined with Recombinant Streptokinase for injection in treatment of acute myocardial infarction. Methods Patients (80 cases) with acute myocardial infarction in Tianjin Fourth Central Hospital from October 2019 to November 2020 were randomly divided into the control group (40 cases) and the treatment group (40 cases). Patients in the control group were administered with Recombinant Streptokinase for injection, 2.0 million UI added into 20 mL normal saline intravenous injection, and 3.0 million UI added into 100 mL normal saline intravenous drip with a temporary doctor's order. Patients in the treatment group were po administered with Qishen Yiqi Dropping Pills on the basis of the control group, 0.5 g/time, three times daily, treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and cardiac function index, myocardial infarction area and serum factor levels in two groups were compared. Results After treatment, the total effective rate of the treatment group was 95.00%, and that of the control group was 77.50%, and there was significant difference between two groups (P<0.05). After treatment, the levels of CRP, IL-6, and NT-proBNP in two groups were significantly lower than those before treatment (P<0.05), and the levels of CRP, IL-6 and NT-proBNP in the treatment group were lower than those in the control group (P<0.05). After treatment, the LVMI, LVEF, E/A of two groups were significantly increased, but the IVST was significantly decreased (P<0.05). After treatment, the LVMI, LVEF, E/A of the treatment group were higher than those of the control group, but the IVST of the treatment group was lower than that of the control group (P<0.05). After treatment, the myocardial infarction area of two groups were significantly decreased (P<0.05), and the myocardial infarction area of the treatment group was lower than that of the control group (P<0.05). Conclusion Qishen Yiqi Dropping Pills combined with Recombinant Streptokinase for injection can improve the curative effect of acute myocardial infarction, reduce myocardial infarction area, improve cardiac function, and reduce inflammatory factors.

R972

天津市濱海新區(qū)衛(wèi)生局科技項目（2014BWkY013）