目的 探討瓜蔞皮注射液聯(lián)合替羅非班治療急性心肌梗死患者的臨床療效。方法 選取2022年5月—2024年5月武漢市中醫(yī)醫(yī)院心血管科收治的68例行PCI術(shù)的急性心肌梗死患者，依據(jù)隨機數(shù)字法將患者分為對照組和治療組，每組各34例。對照組靜脈滴注鹽酸替羅非班氯化鈉注射液，100 mL/次，1次/d。治療組在對照組的治療基礎(chǔ)上靜脈滴注瓜蔞皮注射液，4 mL加入生理鹽水100 mL中混合，2次/d。兩組連續(xù)用藥7 d。觀察兩組患者的臨床療效，比較兩組治療前后心肌酶指標、心功能指標、舒適度與生活質(zhì)量綜合評定表（GQOLI-74）評分、血清炎性因子水平的變化情況。結(jié)果 治療后，治療組總有效率94.12%，顯著高于對照組的73.53%（P＜0.05）。治療后，兩組心肌肌鈣蛋白（cTnI）、肌酸激酶同工酶（CK-MB）水平均顯著低于同組治療前（P＜0.05）；治療后，治療組cTnI、CK-MB水平低于對照組（P＜0.05）。治療后，兩組患者左心室射血分數(shù)（LVEF）顯著升高，而左心室舒張末期內(nèi)徑（LVEDD）、左心室收縮末期內(nèi)徑（LVESD）水平降低（P＜0.05）；治療后，治療組LVEF高于對照組，而LVEDD、LVESD水平低于對照組（P＜0.05）。治療后，兩組GQOLI-74評分升高，Sgarblssa評分降低（P＜0.05）；治療后，治療組GQOLI-74評分高于對照組，Sgarblssa評分低于對照組（P＜0.05）。治療后，兩組內(nèi)皮細胞特異性分子1（Endocan）、半乳糖凝集素9（Galectin-9）、白細胞介素17（IL-17）均顯著降低，而攝食抑制因子1（Nesfatin-1）水平顯著升高（P＜0.05）；治療后，治療組Endocan、Galectin-9、IL-17低于對照組，而Nesfatin-1水平高于對照組（P＜0.05）。結(jié)論 瓜蔞皮注射液聯(lián)合替羅非班治療急性心?；颊忒熜э@著，顯著降低機體內(nèi)炎性反應(yīng)，提高患者生活質(zhì)量，值得借鑒與應(yīng)用。

Objective To investigate the therapeutic effect of Gualoupi Injection combined with tirofiban in treatment of acute myocardial infarction. Methods Sixty-eight patients with acute myocardial infarction who underwent PCI in cardiovascular department of Wuhan Hospital of Traditional Chinese Medicine from May 2022 to May 2024 were selected and divided into control group and treatment group according to random number method, with 34 patients in each group. Patients in control group were iv administered with Tirofiban Hydrochloride and Sodium Chloride Injection, 100 mL/time, once daily. Patients in the treatment group were iv administered with Gualoupi Injection on the basis of control group, 4 mL added into 100 mL of normal saline and mixed, twice daily. Both groups were treated continuously for 7 d. The clinical effects of two groups were observed, and the changes of myocardial enzyme indexes, cardiac function indexes, GQOLI-74 scores of comfort and quality of life and serum inflammatory factors before and after treatment were compared between two groups. ResultsAfter treatment, the total effective rate of the treatment group was 94.12%, which was significantly higher than that of control group (73.53%, P < 0.05). After treatment, the levels of cardiac troponin (cTnI) and creatine kinase isoenzyme (CK-MB) in two groups were significantly lower than before treatment (P < 0.05). After treatment, cTnI and CK-MB levels in treatment group were lower than those in control group (P < 0.05). After treatment, LVEF was significantly increased, but LVEDD and LVESD levels were decreased in two groups (P< 0.05). After treatment, LVEF levels in treatment group were higher than those in control group, but LVEDD and LVESD levels were lower than those in control group (P < 0.05). After treatment, GQOLI-74 score was increased, but Sgarblssa score was decreased (P < 0.05). After treatment, the GQOLI-74 score of treatment group was higher than that of control group, and the Sgarblssa score was lower than that of control group (P< 0.05). After treatment, Endocan, Galectin-9, and IL-17 were significantly decreased in both groups, but Nesfatin-1 levels were significantly increased in both groups (P < 0.05). After treatment, Endocan, Galectin-9 and IL-17 levels in the treatment group were lower than those in the control group, but Nesfatin-1 level was higher than that in control group (P < 0.05). Conclusion Gualoupi Injection combined with tirofiban has remarkable curative effect in treatment of acute myocardial infarction, and can significantly reduce the inflammatory response in the body and improve life quality of patients, which is worth learning and applying.

R972

中醫(yī)藥科研立項項目（ZY2021Z008）