目的 探討抗栓膠囊聯(lián)合替格瑞洛治療急性心肌梗死的臨床療效。方法 回顧性分析2019年2月—2021年2月在鄭州大學(xué)附屬洛陽中心醫(yī)院進行治療的98例急性心肌梗死患者，隨機分為對照組和治療組，每組各49例。對照組口服替格瑞洛片，初始180 mg/次，以后90 mg/次，2次/d；治療組在對照組基礎(chǔ)上口服抗栓膠囊，2.4 g/次，3次/d。經(jīng)14 d治療進行效果對比。觀察兩組的臨床療效，比較兩組心功能指標(biāo)和細(xì)胞因子的變化情況。結(jié)果 治療后，治療組總有效率97.96%，顯著高于對照組83.67%（P<0.05）。經(jīng)治療，兩組右心室舒張末期容積（RVEDV）、右心室收縮末期容積（RVESV）、左心室質(zhì)量指數(shù)（LVMI）、左心室重構(gòu)指數(shù)（LVRI）都顯著降低（P<0.05）；治療后，治療組患者心室重構(gòu)參數(shù)均顯著低于對照組（P<0.05）。經(jīng)治療，兩組血清成纖維細(xì)胞生長因子23（FGF-23）、心型脂肪酸結(jié)合蛋白（H-FABP）、生長分化因子-15（GDF-15）、肌鈣蛋白I（cTnI）、N-末端腦鈉肽前體（NT-proBNP）水平均較治療前顯著降低，但凝集蛋白-1（ITLN-1）顯著升高（P<0.05）；治療后，治療組細(xì)胞因子水平優(yōu)于對照組（P<0.05）。結(jié)論 抗栓膠囊聯(lián)合替格瑞洛治療急性心肌梗死可有效改善患者心功能，促進機體細(xì)胞因子水平及心室重構(gòu)的改善，有著良好的臨床應(yīng)用價值。

Objective To investigate the clinical efficacy of Kangshuan Capsules combined with ticagrelor in treatment of acute myocardial infarction. Methods A retrospective analysis was conducted on 98 patients with acute myocardial infarction who were treated in Luoyang Central Hospital Affiliated to Zhengzhou University from February 2019 to February 2021, and they were randomly divided into control group and treatment group, with 49 patients in each group. Patients in the control group were po administered with Ticagrelor Tablets, initially 180 mg/time, then 90 mg/time, twice daily. Patients in the treatment group were po administered with Kangshuan Capsules on the basis of the control group, 2.4 g/time, three times daily. The effects were compared after 14 d of treatment. The clinical efficacy of the two groups was observed, and the changes of cardiac function indexes and cytokines were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 97.96%, significantly higher than that of the control group (83.67%, P<0.05). After treatment, right ventricular end-diastolic volume (RVEDV), right ventricular end-systolic volume (RVESV), left ventricular mass index (LVMI), and left ventricular remodeling index (LVRI) were significantly decreased in both groups (P<0.05). After treatment, ventricular remodeling parameters in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, serum fibroblast growth factor 23 (FGF-23), heart type fatty acid binding protein (H-FABP), growth differentiation factor-15 (GDF-15), troponin I (cTnI), and N-terminal brain natriuretic peptide precursor (NT-proBNP) levels were significantly decreased in both groups compared with before treatment, but agglutinin-1 (ITLN-1) levels were significantly increased (P<0.05). After treatment, the cytokine level in the treatment group was better than that in the control group (P<0.05). Conclusion Kangshuan Capsules combined with ticagrelor can effectively improve patients' cardiac function in treatment of acute myocardial infarction, and can promote the improvement of cytokine levels and ventricular remodeling, which has good clinical application value.

R972

河南省醫(yī)學(xué)科技攻關(guān)計劃聯(lián)合共建項目[豫衛(wèi)科教函(2020)13號]