目的 探討麝香心腦樂片聯(lián)合硫酸氫氯吡格雷片對急性ST段抬高型心肌梗死患者的臨床療效。方法 選取2019年1月—2020年12月鄭州大學(xué)第五附屬醫(yī)院收治的98例急性ST段抬高型心肌梗死患者，按隨機(jī)數(shù)字表法分為對照組和治療組，每組各49例。對照組患者口服硫酸氫氯吡格雷片，300 mg/次，1次/d，連續(xù)服用7 d后改為75 mg/次，1次/d。治療組在對照組基礎(chǔ)上口服麝香心腦樂片，3片/次，3次/d。兩組均持續(xù)治療24周。觀察兩組的臨床療效，比較兩組的心功能、心肌損傷標(biāo)志物以及血清血管緊張素Ⅱ（Ang Ⅱ）、內(nèi)皮素-1（ET-1）、腫瘤壞死因子α（TNF-α）水平。結(jié)果 治療后，治療組總有效率為91.84%，高于對照組的總有效率73.47%（P<0.05）。治療后，兩組左心室射血分?jǐn)?shù)（LVEF）均高于治療前，左心室舒張末期容積內(nèi)徑（LVEDD）、左心室收縮末期容積內(nèi)徑（LVESD）均小于治療前（P<0.05）；且治療組LVEF高于對照組，LVEDD、LVESD均小于對照組（P<0.05）。治療后，兩組血清心肌鈣蛋白（cTnI）、肌酸激酶同工酶（CK-MB）水平均低于治療前（P<0.05）；且治療組血清cTnI、CK-MB水平均低于對照組（P<0.05）。治療后，兩組血清Ang Ⅱ、ET-1、TNF-α水平均低于治療前（P<0.05）；且治療組血清Ang Ⅱ、ET-1、TNF-α水平均低于對照組（P<0.05）。結(jié)論 麝香心腦樂片聯(lián)合硫酸氫氯吡格雷片治療急性ST段抬高型心肌梗死臨床療效肯定，能改善心功能，調(diào)節(jié)血清cTnI、CK-MB、Ang Ⅱ、ET-1、TNF-α水平，且臨床應(yīng)用安全性較好。

Objective To investigate the clinical effect of Shexiang Xinnaole Tablets combined with Clopidogrel Bisulfate Tablets in treatment of acute ST-segment elevation myocardial infarction. Methods Patients (98 cases) with acute ST-segment elevation myocardial infarction in the Fifth Affiliated Hospital of Zhengzhou University from January 2019 to December 2020 were randomly divided into control and treatment groups, and each group had 49 cases. Patients in the control group were po administered with Clopidogrel Bisulfate Tablets, 300 mg/time, once daily, after taking 7 d continuously, and it was changed to 75 mg/times, once daily. Patients in the treatment group were po administered with Shexiang Xinnaole Tablets on the basis of the control group, 3 tablets/time, three times daily. Patients in two groups were treated for 24 weeks. After treatment, the clinical efficacies were evaluated, and cardiac function, myocardial injury markers, the levels of Ang Ⅱ, ET-1, and TNF-α in two groups were compared. Results After treatment, the total effective rate in the treatment group was 91.84%, which was higher than 73.47% in the control group (P<0.05). After treatment, the LVEF in two groups was higher than that before treatment, but the LVEDD and LVESD in two groups were lower than those before treatment (P<0.05). The LVEF in the treatment group was higher than that in the control group, but the LVEDD and LVESD in the treatment were lower than those in the control group (P<0.05). After treatment, the serum levels of cTnT and CK-MB in two groups were lower than those before treatment (P<0.05). The serum levels of cTnI and CK-MB in the treatment group were lower than those in the control group (P<0.05). After treatment, the serum levels of Ang Ⅱ, ET-1, and TNF-α in two groups were lower than those before treatment (P<0.05). The serum levels of Ang Ⅱ, ET-1, and TNF-α in the treatment group were lower than those in the control group (P<0.05). Conclusion Shexiang Xinnaole Tablets combined with Clopidogrel Bisulfate Tablets has a positive clinical effect in treatment of acute ST-segment elevation myocardial infarction, which can improve heart function, and regulate the serum levels of cTnI, CK-MB, Ang Ⅱ, ET-1, and TNF-α, with good safety.

R972

河南省科技攻關(guān)計(jì)劃項(xiàng)目（172102310265）