目的 探討替羅非班聯(lián)合美托洛爾治療心肌梗死患者的臨床效果。方法 選取2017年6月-2019年6月在周口豫東醫(yī)院治療的心肌梗死患者118例，隨機(jī)分為對(duì)照組和治療組，每組各59例。對(duì)照組患者口服酒石酸美托洛爾片，前期劑量6.25 mg/次，2~3次/d，根據(jù)患者病情增加藥量，每次增加6.25~12.5 mg，最大劑量50~100 mg，2次/d，兩周為1個(gè)療程。治療組在對(duì)照組的基礎(chǔ)上靜脈滴注鹽酸替羅非班氯化鈉注射液，初始劑量8μg/kg，用藥后未見(jiàn)不良反應(yīng)者調(diào)整滴速4μg/（kg·h），維持治療24 h，連續(xù)治療2周。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者收縮壓、舒張壓、心率指標(biāo)、心功能和不良反應(yīng)。結(jié)果 治療后，對(duì)照組和治療組總有效率分別為67.80%和94.92%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組收縮壓、舒張壓、心率水平顯著下降，且治療組各項(xiàng)標(biāo)準(zhǔn)均優(yōu)于對(duì)照組（P<0.05）。治療后，兩組心功能指標(biāo)明顯改善，而治療組患者左室舒張末數(shù)（LVEDD）、左心室收縮末期內(nèi)徑（LVESD）指標(biāo)均顯著低于對(duì)照組（P<0.05），心臟指數(shù)（CI）、左心室射血分?jǐn)?shù)（LVEF）、心輸血量（CO）高于對(duì)照組（P<0.05）。治療期間，治療組的不良事件發(fā)生率明顯低于對(duì)照組（P<0.05）。結(jié)論 替羅非班聯(lián)合美托洛爾治療心肌梗死患者效果顯著，有利于調(diào)節(jié)和改善患者左心室射血分?jǐn)?shù)，安全性較高。

Objective To investigate the clinical effect of tirofiban combined with metoprolol in treatment of acute myocardial infarction. Methods Patients (118) with acute myocardial infarction in Zhoukou Yudong Hospital from June 2017 to June 2019 were randomly divided into control and treatment groups, and each group had 59 cases. Patients in the control group were po administered with Metoprolol Tartrate Tablets, the prophase dosage was 6.25 mg/time, 2-3 times daily, then the dosage was increased according to the patient's condition with 6.25-12.5 mg each time, and the maximum dosage was 50-100 mg, twice daily. Two weeks was as a course of treatment. Patients in the treatment group were iv administered with Tirofiban Hydrochloride and Sodium Chloride Injection on the basis of the control group, and the initial dosage was 8 μg/kg. If there was no adverse reaction, the dropping rate adjusted to 4 μg/(kg·h), maintained the treatment for 24 h, they were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the clinical indicators, the cardiac function, the adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 67.80% and 94.92%, respectively, and there were differences between two groups (P<0.05). After treatment, the systolic blood pressure, diastolic blood pressure, and heart rate in two groups were significantly decreased (P<0.05), and these clinical indicators in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the cardiac function in two groups was significantly improved (P<0.05), and the LVEDD and LVESD in the treatment group were significantly lower than those in the control group (P<0.05), but the CI, LVEF, and CO in the treatment group were significantly higher than those in the control group (P<0.05). During the treatment, the incidence of adverse reactions in the treatment group was significantly lower than that in the control group (P<0.05). Conclusion Metoprolol combined with tirofiban has a significant therapeutic effect in treatment of acute myocardial infarction, which is beneficial to adjust and improve the left ventricular ejection fraction with high safety.

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