目的 考察通心絡(luò)膠囊聯(lián)合注射用尿激酶治療急性ST段抬高型心肌梗死的臨床療效。方法 選取2017年6月-2019年12月在天津市第三中心醫(yī)院分院治療的120例急性ST段抬高型心肌梗死患者，所有患者隨機(jī)分為對(duì)照組和治療組，每組各60例。對(duì)照組患者給予注射用尿激酶，將注射用尿激酶溶于生理鹽水，按6 000 U/min冠狀動(dòng)脈內(nèi)連續(xù)滴注2 h。治療組在對(duì)照組基礎(chǔ)上口服通心絡(luò)膠囊，3粒/次，3次/d。兩組患者持續(xù)治療2周。觀察兩組患者臨床療效，比較兩組的心功能指標(biāo)、血流變學(xué)指標(biāo)、血清學(xué)指標(biāo)、血清炎性因子水平。結(jié)果 治療后，治療組總有效率96.67%顯著較對(duì)照組的83.33%高（P<0.05）。治療后，兩組患者左心室舒張末期內(nèi)徑（LVEDD）、左心室收縮末期內(nèi)徑（LVESD）顯著降低，左室射血分?jǐn)?shù)（LVEF）顯著升高（P<0.05），且治療組左心功能指標(biāo)改善較多（P<0.05）。治療后，兩組患者血清血漿黏度（PV）、纖維蛋白原（FIB）、D-二聚體（D-D）水平顯著降低（P<0.05）；且治療組血液流變學(xué)指標(biāo)水平降低較明顯（P<0.05）。治療后，兩組血清N末端B型鈉尿肽原（NT-proBNP）和肌鈣蛋白T（cTnT）水平顯著降低（P<0.05）；并且治療組血清NT-proBNP和cTnT水平降低較明顯（P<0.05）。治療后，兩組血清超敏C-反應(yīng)蛋白（hs-CRP）水平顯著降低（P<0.05）；并且治療組血清hs-CRP水平降低較多（P<0.05）。結(jié)論 通心絡(luò)膠囊聯(lián)合注射用尿激酶治療急性ST段抬高型心肌梗死具有較好的治療效果，能夠改善心功能，降低血液流變學(xué)指標(biāo)和血清NT-proBNP、cTnT、hs-CRP水平。

Objective To study the efficacy of Tongxinluo Capsules combined with Urokinase for injection in treatment of acute ST-segment elevation myocardial infarction. Methods Patients (120 cases) with acute ST-segment elevation myocardial infarction in Branch of Tianjin Third Central Hospital from June 2017 to December 2019 were randomly divided into control and treatment groups, and each group had 60 cases. Patients in the control group were given Urokinase for injection, and the drug was dissolved in normal saline and continuously injected into the coronary artery at 6 000 U/min for 2 h. Patients in the treatment group were po administered with Tongxinluo Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and cardiac function index, hemorheology index, serological index, and serum inflammatory factor level in two groups were compared. Results After treatment, the total effective rate of 96.67% in the treatment group was significantly higher than 83.33% in the control group (P < 0.05). After treatment, LVEDD and LVESD in two groups were significantly decreased, but LVEF in two groups was significantly increased (P < 0.05), and the indexes of left ventricular function in the treatment group were improved more than those in the control group (P < 0.05). After treatment, the levels of PV, FIB, and D-D in two groups were significantly decreased (P < 0.05), and the levels of hemorheology in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the levels of NT-proBNP and cTnT in two groups were significantly decreased (P < 0.05), and the levels of serum NT-proBNP and cTnT in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of hs-CRP in two groups were significantly decreased (P < 0.05), and the serum level of hs-CRP in the treatment group decreased more than that in the control group (P < 0.05). Conclusion Tongxinluo Capsules combined with Urokinase for injection has clinical curative effect in treatment of acute ST-segment elevation myocardial infarction, can improve cardiac function, reduce hemorheology indexes and the serum levels of NT-proBNP, cTnT, hs-CRP.

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