目的 探讨芪参益气滴丸联合注射用重组链激酶治疗急性心肌梗死的临床疗效。方法 选取2019年10月—2020年11月在天津市第四中心医院就诊的80例急性心肌梗死患者，根据随机数字表法将80例患者分为对照组（40例）和治疗组（40例）。对照组给予注射用重组链激酶，200万UI加入20 mL生理盐水中静推，300万UI加入100 mL生理盐水中静点，临时1次。治疗组在对照组治疗的基础上口服芪参益气滴丸，0.5 g/次，3次/d，连续治疗4周。观察两组的临床疗效，比较两组治疗前后心肌梗死面积、心功能指标和血清因子水平。结果 治疗后，治疗组的总有效率为95.00%，对照组总有效率为77.50%，组间对比有明显差异（P<0.05）。治疗后，两组的心肌梗死面积明显减少（P<0.05），且治疗组心肌梗死面积明显小于对照组（P<0.05）。两组治疗后的C反应蛋白（CRP）、白细胞介素-6（IL-6）、N末端B型利钠肽原（NT-proBNP）水平明显低于治疗前（P<0.05）；治疗组的CRP、IL-6、NT-proBNP比对照组低（P<0.05）。治疗后，两组的左室质量指数（LVMI）、左室射血分数（LVEF）、左房室瓣E峰和A峰最大流速比值（E/A）均明显升高，室间隔舒张末期厚度（IVST）明显降低（P<0.05）；治疗后，治疗组患者的LVMI、LVEF、E/A高于对照组，IVST低于对照组（P<0.05）。结论 芪参益气滴丸联合注射用重组链激酶可提高急性心肌梗死的疗效，缩小心肌梗死面积，改善心功能，降低炎症因子。

Objective To investigate the clinical efficacy of Qishen Yiqi Dropping Pills combined with Recombinant Streptokinase for injection in treatment of acute myocardial infarction. Methods Patients (80 cases) with acute myocardial infarction in Tianjin Fourth Central Hospital from October 2019 to November 2020 were randomly divided into the control group (40 cases) and the treatment group (40 cases). Patients in the control group were administered with Recombinant Streptokinase for injection, 2.0 million UI added into 20 mL normal saline intravenous injection, and 3.0 million UI added into 100 mL normal saline intravenous drip with a temporary doctor's order. Patients in the treatment group were po administered with Qishen Yiqi Dropping Pills on the basis of the control group, 0.5 g/time, three times daily, treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and cardiac function index, myocardial infarction area and serum factor levels in two groups were compared. Results After treatment, the total effective rate of the treatment group was 95.00%, and that of the control group was 77.50%, and there was significant difference between two groups (P<0.05). After treatment, the levels of CRP, IL-6, and NT-proBNP in two groups were significantly lower than those before treatment (P<0.05), and the levels of CRP, IL-6 and NT-proBNP in the treatment group were lower than those in the control group (P<0.05). After treatment, the LVMI, LVEF, E/A of two groups were significantly increased, but the IVST was significantly decreased (P<0.05). After treatment, the LVMI, LVEF, E/A of the treatment group were higher than those of the control group, but the IVST of the treatment group was lower than that of the control group (P<0.05). After treatment, the myocardial infarction area of two groups were significantly decreased (P<0.05), and the myocardial infarction area of the treatment group was lower than that of the control group (P<0.05). Conclusion Qishen Yiqi Dropping Pills combined with Recombinant Streptokinase for injection can improve the curative effect of acute myocardial infarction, reduce myocardial infarction area, improve cardiac function, and reduce inflammatory factors.

R972

天津市滨海新区卫生局科技项目（2014BWkY013）