目的 探討?zhàn)B心定悸膠囊聯(lián)合阿托伐他汀鈣片治療急性心肌梗死的臨床療效。方法 選取2019年10月—2021年5月天津市寧河區(qū)醫(yī)院收治的總共82例急性心肌梗死患者，按照隨機數(shù)字表法將所有患者分為對照組和治療組，每組各41例。對照組口服阿托伐他汀鈣片，20 mg/次，1次/d。治療組在對照組基礎上口服養(yǎng)心定悸膠囊，6粒/次，2次/d。兩組患者共治療4周。觀察兩組的臨床療效，比較兩組患者治療前后心肌梗死面積的變化、心功能指標[左心室射血分數(shù)（LVEF）、心輸出量（CO）]以及血清脂質指標脂蛋白（a）[Lp （a）]、載脂蛋白[Apo （a）]、一氧化氮（NO）、內皮素-1（ET-1）水平。結果 治療后，治療組患者的總有效率（87.80%）明顯高于對照組的總有效率（68.29%）（P<0.05）。治療后，兩組的心肌梗死面積顯著縮小（P<0.05），且治療組心肌梗死面積縮小更明顯（P<0.05）。治療后，兩組的LVEF、CO明顯升高（P<0.05），治療組LVEF、CO較對照組升高更明顯（P<0.05）。治療后，兩組的Lp （a）、Apo （a）、ET-1水平明顯降低，NO水平明顯升高（P<0.05）；治療組的Lp （a）、Apo （a）、ET-1水平低于對照組，NO水平高于對照組，差異有統(tǒng)計學意義（P<0.05）。結論 養(yǎng)心定悸膠囊聯(lián)合阿托伐他汀鈣片可提高急性心肌梗死的療效，能縮小心肌梗死面積，提高心功能，改善血脂代謝水平，且安全性良好。

Objective To investigate the clinical efficacy of Yangxin Dingji Capsules combined with Atorvastatin Calcium Tablets in treatment of acute myocardial infarction. Methods Patients (82 cases) with acute myocardial infarction in Tianjin Ninghe Hospital from October 2019 to May 2021 were randomly divided into control and treatment groups, and each group had 41 cases. Patients in the control group were po administered with Atorvastatin Calcium Tablets, 20 mg/time, once daily. Patients in the treatment group were po administered with Yangxin Dingji Capsules on the basis of the control group, 6 grains/time, twice daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and the myocardial infarction area, LVEF and CO of cardiac function indexes, and the serum levels of LP(a), Apo(a), NO, and ET-1 in two groups were compared. Results After treatment, the total effective rate of the treatment group (87.80%) was significantly higher than that of the control group (68.29%) (P<0.05). After treatment, the myocardial infarction area in two groups were significantly decreased (P<0.05), and the myocardial infarction area in the treatment group was significantly smaller than that in the control group (P<0.05). After treatment, LVEF and CO in two groups were significantly increased (P<0.05), and LVEF and CO in the treatment group was significantly higher than that in the control group (P<0.05). After treatment, the levels of LP(a), Apo(a), and ET-1 in two groups were significantly decreased, but levels of NO in two groups were significantly increased (P<0.05). The levels of LP(a), Apo(a) and ET-1 in the treatment group were lower than those in the control group, but level of NO in the treatment group was higher than those in the control group (P<0.05). Conclusion Yangxin Dingji Capsules combined with Atorvastatin Calcium Tablets can improve the curative effect of acute myocardial infarction, reduce the area of myocardial infarction, improve cardiac function, and improve the level of blood lipid metabolism, with good safety.

R972

河北省中醫(yī)藥管理局科研計劃項目（2019311）