目的 探讨抗栓胶囊联合替格瑞洛治疗急性心肌梗死的临床疗效。方法 回顾性分析2019年2月—2021年2月在郑州大学附属洛阳中心医院进行治疗的98例急性心肌梗死患者，随机分为对照组和治疗组，每组各49例。对照组口服替格瑞洛片，初始180 mg/次，以后90 mg/次，2次/d；治疗组在对照组基础上口服抗栓胶囊，2.4 g/次，3次/d。经14 d治疗进行效果对比。观察两组的临床疗效，比较两组心功能指标和细胞因子的变化情况。结果 治疗后，治疗组总有效率97.96%，显著高于对照组83.67%（P<0.05）。经治疗，两组右心室舒张末期容积（RVEDV）、右心室收缩末期容积（RVESV）、左心室质量指数（LVMI）、左心室重构指数（LVRI）都显著降低（P<0.05）；治疗后，治疗组患者心室重构参数均显著低于对照组（P<0.05）。经治疗，两组血清成纤维细胞生长因子23（FGF-23）、心型脂肪酸结合蛋白（H-FABP）、生长分化因子-15（GDF-15）、肌钙蛋白I（cTnI）、N-末端脑钠肽前体（NT-proBNP）水平均较治疗前显著降低，但凝集蛋白-1（ITLN-1）显著升高（P<0.05）；治疗后，治疗组细胞因子水平优于对照组（P<0.05）。结论 抗栓胶囊联合替格瑞洛治疗急性心肌梗死可有效改善患者心功能，促进机体细胞因子水平及心室重构的改善，有着良好的临床应用价值。

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

河南省医学科技攻关计划联合共建项目[豫卫科教函(2020)13号]