目的 探討舒血寧注射液聯(lián)合替羅非班治療急性心肌梗死行急診經(jīng)皮冠狀動脈介入（PCI）術(shù)患者的臨床研究療效。方法 選取2018年7月—2021年7月在蕪湖市第二人民醫(yī)院治療的60例急性心肌梗死患者為研究對象，根據(jù)用藥差別分為對照組和治療組，每組各30例。對照組冠脈內(nèi)注射鹽酸替羅非班氯化鈉注射液，急診PCI術(shù)中給予10μg/kg，術(shù)后0.15 μg/（kg·min），持續(xù)靜脈泵入24 h；在對照組基礎(chǔ)上，治療組術(shù)后靜脈滴注舒血寧注射液，20 mg/次加入5%葡萄糖注射液250 mL中，1次/d。兩組患者至少治療3 d。觀察兩組患者臨床療效，比較治療前后兩組患者Sgarblssa評分、Selvester QRS評分、GQOLI-74評分和Barthel指數(shù)評分，心功能指標(biāo)左心室射血分?jǐn)?shù)（LVEF）、左心室舒張末期內(nèi)徑（LVEDD）、左心室收縮末期內(nèi)徑（LVESD）、每搏輸出量（SV）和二尖瓣舒張早期血流峰速度與二尖瓣環(huán)舒張早期運(yùn)動峰速度之比（E/Em），血清可溶性P選擇素（sP-sel）、單核細(xì)胞趨化蛋白-1（MCP-1）、補(bǔ)體C1q/腫瘤壞死抑制相關(guān)蛋白3（CTRP3）、去整合素-金屬蛋酶9（ADAM9）、炎癥細(xì)胞因子粒巨噬細(xì)胞集落刺激因子受體α（CSF2RA）、和肽素水平。結(jié)果 治療后，對照組總有效率為80.00%，明顯低于治療組的100.00%（P<0.05）。治療后，兩組改良Sgarblssa評分和Selvester QRS評分明顯下降，而GQOLI-74評分和Barthel指數(shù)評分均明顯升高（P<0.05），并以治療組積分改善最為明顯（P<0.05）。治療后，兩組LVEF和SV明顯升高，而LVEDD、LVESD和E/Em明顯下降（P<0.05），并以治療組心功能改善最為明顯（P<0.05）。治療后，兩組患者血清sP-sel、MCP-1、ADAM9、CSF2RA、和肽素水平明顯降低，而CTRP3水平明顯升高（P<0.05），并以治療組改善最為明顯（P<0.05）。結(jié)論 舒血寧注射液聯(lián)合替羅非班治療急性心肌梗死行PCI術(shù)患者可有改善機(jī)體細(xì)胞因子水平，提高患者生活質(zhì)量及日常生活能力，有效降低心肌梗死面積。

Objective To investigate the clinical efficacy of Shuxuening Injection combined with tirofiban in treatment of in treatment of acute myocardial infarction patients undergoing emergency percutaneous coronary intervention (PCI). Methods Patients (60 cases) with acute myocardial infarction in the Second People's Hospital of Wuhu from July 2018 to July 2021 were randomly divided into control and treatment group, and each group had 30 cases. Patients in the control group were intracoronary injection administered with Tirofiban Hydrochloride and Sodium Chloride Injection, 10 μg/kg during emergency PCI, postoperative 0.15 μg/(kg∙min), continuous intravenous pumping for 24 h. Patients in the treatment group were iv administered with Shuxuening Injection on the basis of the control group, 20 mg added into 5% glucose injection 250 mL, once daily. Patients in two groups were treated for at least 3 d. After treatment, the clinical evaluation was evaluated, the scores of Sgarblssa, Selvester QRS, GQOLI-74 and Barthel, cardiac function indexes of LVEF, SV, LVEDD, LVESD and E/Em, and the levels of serum sP-sel, MCP-1, ADAM9, CSF2RA, copeptin and CTRP3 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the control group was 80.005%, which was significantly lower than that in the treatment group (100.005%, P < 0.05). After treatment, the modified Sgarblssa score and Selvester QRS score were significantly decreased, while the GQOLI-74 score and Barthel index score were significantly increased in two groups (P < 0.05), especially in the treatment group (P < 0.05). After treatment, LVEF and SV were significantly increased, while LVEDD, LVESD and E/Em were significantly decreased in two groups (P < 0.05), and the improvement of cardiac function was the most obvious in the treatment group (P < 0.05). After treatment, the levels of serum sP-sel, MCP-1, ADAM9, CSF2RA and copeptin in the two groups were significantly decreased, while the level of CTRP3 were significantly increased (P < 0.05), especially in the treatment group (P < 0.05). Conclusion Shuxuening Injection combined with tirofiban can improve the level of cytokines in treatment of acute myocardial infarction patients undergoing emergency percutaneous coronary intervention, improve the quality of life and ability of daily living of patients, and effectively reduce the area of myocardial infarction.

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