目的 探討可達(dá)靈片聯(lián)合替羅非班治療非ST段抬高型心肌梗死的安全性與有效性。方法 選取2020年1月—2021年1月于開(kāi)封市中心醫(yī)院診治的99例非ST段抬高型心肌梗死患者，根據(jù)入組順序分成對(duì)照組（50例）和治療組（49例）。對(duì)照組患者靜脈滴注鹽酸替羅非班氯化鈉注射液，起始滴加速度為0.4μg/（kg∙min），0.5 h后以0.1μg/（kg∙min）維持，連續(xù)治療72 h；治療組在對(duì)照組基礎(chǔ)上口服可達(dá)靈片，3片/次，3次/d。兩組患者治療2周。觀(guān)察兩組患者臨床療效，比較治療前后兩組患者SF-36、GRACE和VAS評(píng)分，血清心型脂肪酸結(jié)合蛋白（H-FABP）、和肽素和同型半胱氨酸（Hcy）水平及不良反應(yīng)情況。結(jié)果 治療后，治療組總有效率為94.00%，明顯高于對(duì)照組的75.51%（P<0.05）。治療后，兩組患者SF-36評(píng)分明顯升高，而GRACE和VAS評(píng)分顯著降低（P<0.05），且治療組評(píng)分明顯優(yōu)于對(duì)照組（P<0.05）。治療后，兩組患者血清H-FABP、和肽素和Hcy水平均顯著降低（P<0.05），且治療組明顯低于對(duì)照組（P<0.05）。治療期間，治療組不良反應(yīng)發(fā)生率明顯低于對(duì)照組（4.00%vs 18.37%，P<0.05）。結(jié)論 可達(dá)靈片聯(lián)合替羅非班能夠顯著提升非ST段抬高型心肌梗死患者的臨床治療效果，改善患者的危險(xiǎn)程度和生活質(zhì)量，調(diào)節(jié)血清因子水平，安全性較高。

Objective To investigate the safety and efficacy of Kedaling Tablets combined with tirofiban in treatment of non-ST segment elevation myocardial infarction. Methods Patients (99 cases) with non-ST segment elevation myocardial infarction in Kaifeng Central Hospital from January 2020 to January 2021 were randomly divided into control (50 cases) and treatment (49 cases) groups. Patients in the control group were iv administered with Tirofiban Hydrochloride and Sodium Chloride Injection, the initial drop acceleration was 0.4 μg/(kg∙min), and maintained with 0.1 μg/(kg∙min) after 0.5 h, they were continuously treated for 72 h. Patients in the treatment group were po administered with Kedaling Tablets, 3 tablets/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, the scores of SF-36, GRACE, and VAS, the levels of serum H-FABP, copeptin, and Hcy, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the treatment group was 94.00%, which was significantly higher than 75.51% in the control group (P < 0.05). After treatment, the SF-36 score in two groups was significantly increased, while the scores of GRACE and VAS were significantly decreased (P < 0.05), and these scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the levels of serum H-FABP, peptidatin, and Hcy in two groups were significantly decreased (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). During the treatment, the incidence of adverse reactions in the treatment group was significantly lower than that in the control group (4.00% vs 18.37%, P < 0.05). Conclusion Kedaling Tablets combined with tirofiban can significantly improve the clinical therapeutic effect of patients with non-ST segment elevation myocardial infarction, which is safe to improve the risk degree and quality of life of patients and regulate the level of serum factors.

R972

河南省科技計(jì)劃廳項(xiàng)目（豫科[2016]19號(hào)）