目的 探討替羅非班聯(lián)合氯吡格雷治療急性心肌梗死的臨床療效和安全性。方法 選自南陽市第二人民醫(yī)院于2018年3月—2019年6月收治的86例急性心肌梗死患者，按照治療方式的不同分為對照組和治療組，每組各43例。對照組患者口服硫酸氫氯吡格雷片，首次用藥量為300 mg/次，之后縮減至75 mg/次，1次/d。治療組患者在對照組的基礎上靜脈滴注鹽酸替羅非班注射液0.4 μg/（kg·min），30 min后，調整為0.1 μg/（kg·min）。兩組患者均以7 d為1個療程，連續(xù)治療2個療程。觀察兩組的臨床療效，比較兩組心功能指標、血清炎性因子水平的變化情況。結果 治療后，治療組總有效率是95.3%，顯著高于對照組的83.7%（P<0.05）。治療后，兩組心功能與治療前相比均有所降低（P<0.05），治療組低于對照組（P<0.05）。治療后，兩組患者血清炎性因子水平均有所下降（P<0.05），且治療組下降情況優(yōu)于對照組（P<0.05）。治療組不良反應發(fā)生率是9.3%，顯著低于對照組的28.0%（P<0.05）。結論 替羅非班聯(lián)合氯吡格雷治療急性心肌梗死臨床效果顯著，可改善炎性因子水平及心功能狀況，不良反應發(fā)生率低，具有一定的臨床推廣應用價值。

Objective To investigate the clinical effect and safety of tirofeban combined with clopidogrel in the treatment of acute myocardial infarction. Methods A total of 86 patients with acute myocardial infarction admitted to Nanyang Second People's Hospital from March 2018 to June 2019 were selected and divided into control group and treatment group according to different treatment methods, with 43 patients in each group. Patients in the control group were po administered with Clopidogrel Hydrogen Sulphate Tablets, the first dosage was 300 mg/time, and then the dosage was reduced to 75 mg/time, once daily. Patients in the treatment group were iv administered with Tirofiban Hydrochloride Injection, 0.4 μg/kg·min on the basis of the control group, which was adjusted to 0.1 μg/kg·min after 30 min. Patients in both groups were treated for 7 days as one course of treatment, and they were treated for 2 courses consecutively. The clinical efficacy of the two groups was observed, and the changes of cardiac function indicators and serum inflammatory factors were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 95.3%, significantly higher than that of the control group (83.7%, P<0.05). After treatment, cardiac function of both groups was improved compared with that before treatment (P<0.05), and the treatment group was better than the control group (P<0.05). After treatment, the level of serum inflammatory factors decreased in both groups (P<0.05), and the reduction in the treatment group was better than that in the control group (P<0.05). The incidence of adverse reactions in the treatment group was 9.3%, significantly lower than that in the control group (28.0%, P<0.05). Conclusion Tirofiban combined with clopidogrel has a significant clinical effect in the treatment of acute myocardial infarction, and can improve the level of inflammatory factors and cardiac function, with low incidence of adverse reactions, which has a certain clinical application value.

R972