目的 探討銀杏達(dá)莫注射液聯(lián)合硫酸氫氯吡格雷片治療急性冠脈綜合征的臨床療效。方法 選取2016年3月-2017年3月在西安醫(yī)學(xué)院第二附屬醫(yī)院進(jìn)行治療的急性冠脈綜合征患者78例為研究對(duì)象，根據(jù)所有患者用藥的差別分為對(duì)照組和治療組，每組各39例。對(duì)照組口服硫酸氫氯吡格雷片，首次劑量300 mg/次，爾后75 mg/次，1次/d。治療組在對(duì)照組基礎(chǔ)上靜脈注射銀杏達(dá)莫注射液，20 mL加入到0.9%氯化鈉注射液250 mL中，2次/d。兩組均連續(xù)治療14 d。觀察兩組的臨床療效，比較兩組的心電圖（ECG）療效、心功能指標(biāo)、心絞痛發(fā)作次數(shù)、心絞痛持續(xù)時(shí)間和血清學(xué)指標(biāo)。結(jié)果 治療后，對(duì)照組和治療組的總有效率和ECG有效率分別均為79.49%、94.87%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組LVEF和LVEDD顯著升高，而LVEDV明顯下降，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組心絞痛發(fā)作次數(shù)和持續(xù)時(shí)間明顯降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)明顯低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組血清hs-CRP、MMP-9、ET-1、TN-C水平明顯降低，而NO水平明顯升高，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 銀杏達(dá)莫注射液聯(lián)合硫酸氫氯吡格雷片治療急性冠脈綜合征具有較好的臨床療效，可改善患者心功能和血管內(nèi)皮功能，降低機(jī)體炎癥反應(yīng)，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy of Ginkgo Leaf Extract and Dipyridamole Injection combined with Clopidogrel Hydrogen Sulphate Tablets in treatment of acute coronary syndrome. Methods Patients (78 cases) with acute coronary syndrome in the Second Affiliated Hospital of Xi'an Medical College from March 2016 to March 2017 were enrolled in this study. According to the difference treatment plan, patients were divided into control and treatment groups, and each group had 39 cases. Patients in the control group were po administered with Clopidogrel Hydrogen Sulphate Tablets, first dose 300 mg/time, then 75 mg/time, once daily. Patients in the treatment group were iv administered with Ginkgo Leaf Extract and Dipyridamole Injection on the basis of the control group, 20 mL added into normal saline 250 mL, twice daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and ECG efficacies, cardiac function index, frequency and duration of angina pectoris, and serological index in two groups were compared. Results After treatment, the clinical efficacies and ECG efficacies in the control and treatment groups were both 79.49% and 94.87%, respectively, and there was difference between two groups (P<0.05). After treatment, the frequency and duration of angina pectoris in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, LVEF and LVEDD in two groups were significantly increased, but the LVEDV in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of hs-CRP, MMP-9, ET-1, and TN-C in two groups were significantly decreased, but the levels of NO in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Ginkgo Leaf Extract and Dipyridamole Injection combined with clopidogrel has clinical curative effect in treatment of acute coronary syndrome, can improve cardiac function and vascular endothelial function, and reduce inflammatory reaction, which has a certain clinical application value.

陜西省教育廳專項(xiàng)科研計(jì)劃項(xiàng)目（16JK1667）；西安醫(yī)學(xué)院校級(jí)重點(diǎn)建設(shè)學(xué)科基金資助項(xiàng)目（16JK1667）