目的 分析穩(wěn)心顆粒聯(lián)合氯吡格雷治療急性ST段抬高型心肌梗死的臨床療效。方法 選取2021年8月—2023年6月首都醫(yī)科大學(xué)附屬北京友誼醫(yī)院收治的116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(duì)照組和治療組，每組各58例。對(duì)照組口服硫酸氫氯吡格雷片，300 mg/次，1次/d，連服7 d后按75 mg/次，1次/d。治療組在此基礎(chǔ)上開(kāi)水沖服穩(wěn)心顆粒，1袋/次，3次/d。兩組連續(xù)治療4周。比較兩組臨床療效、心臟損傷標(biāo)志物、超聲心動(dòng)圖指標(biāo)及血清淀粉樣蛋白A（SAA）、白細(xì)胞介素-33（IL-33）、血管緊張素1-7[Ang（1-7）]水平。統(tǒng)計(jì)兩組主要不良心臟事件（MACE）情況。結(jié)果 治療后，治療組總有效率是93.10%，顯著高于對(duì)照組的79.31%（P＜0.05）。治療后，兩組血清B型利鈉肽（BNP）、肌酸激酶同工酶（CK-MB）、心肌肌鈣蛋白I（cTnI）、可溶性生長(zhǎng)刺激表達(dá)基因2蛋白（sST2）水平均顯著降低（P＜0.05）；以治療組降低更顯著（P＜0.05）。治療后，兩組左室射血分?jǐn)?shù)（LVEF）均顯著增加，而左心房容積指數(shù)（LAVI）和左心房前后徑（LAD）均顯著降低（P＜0.05）；以治療組改善更顯著（P＜0.05）。治療后，兩組血清SAA、IL-33、Ang（1-7）水平均顯著下降（P＜0.05）；以治療組降低更顯著（P＜0.05）。治療后，治療組MACE發(fā)生率是5.17%，顯著低于對(duì)照組的17.24%（P＜0.05）。結(jié)論 穩(wěn)心顆粒聯(lián)合氯吡格雷治療急性ST段抬高型心肌梗療效及安全性較高，患者心功能得到有效保護(hù)，心肌損害及機(jī)體炎癥程度明顯減輕，心臟不良事件減少，值得臨床推廣應(yīng)用。

Objective To analyze the clinical efficacy of Wenxin Granules combined with clopidogrel in treatment of acute ST segment elevated myocardial infarction. Methods A total of 116 patients with acute ST-segment elevation myocardial infarction admitted to Beijing Friendship Hospital Affiliated to Capital Medical University from August 2021 to June 2023 were selected and divided into control group and treatment group according to random number table method, with 58 cases in each group. Patients in the control group were po administered with Clopidogrel Bisulfate Tablets, 300 mg/time, once daily, after 7 d of continuous administration, 75 mg/d, once daily. Patients in the treatment group were po administered with Wenxin granules on the basis of control group, 1 bag/time, 3 times daily. Both groups were treated continuously for 4 weeks. The clinical efficacy, markers of heart injury, echocardiogram and serum levels of amyloid A (SAA), interleukin-33 (IL-33) and angiotensin 1-7[Ang (1-7)] were compared between two groups. Major adverse cardiac events (MACE) were measured in two groups. Results After treatment, the total effective rate of treatment group was 93.10%, which was significantly higher than 79.31% of control group ( P < 0.05). After treatment, the serum levels of B-type natriuretic peptide (BNP), creatine kinase isoenzyme (CK-MB), cardiac troponin I (cTnI), and soluble growth stimulation expression gene 2 protein (sST2) in 2 groups were significantly decreased (P < 0.05). The decrease was more significant in treatment group (P <0.05). After treatment, left ventricular ejection fraction (LVEF) was significantly increased, but left atrial volume index (LAVI) and left atrial anterior and posterior diameter (LAD) were significantly decreased in both groups (P < 0.05). The improvement was more significant in treatment group (P < 0.05). After treatment, serum levels of SAA, IL-33, and Ang (1-7) in 2 groups were significantly decreased (P < 0.05). The decrease was more significant in treatment group (P < 0.05). After treatment, the incidence of MACE in treatment group was 5.17%, which was significantly lower than that in control group (17.24%, P < 0.05). Conclusion Wenxin Granules combined with clopidogrel has high efficacy and safety in treatment of acute ST segment elevated myocardial infarction, and can effectively protects the cardiac function of patients, significantly reduces the degree of myocardial damage and body inflammation, and reduces cardiac adverse events, which is worthy of clinical promotion and application.

R972

北京市“青苗”計(jì)劃項(xiàng)目（QML20181906）