目的 探讨可达灵片联合替罗非班治疗非ST段抬高型心肌梗死的安全性与有效性。方法 选取2020年1月—2021年1月于开封市中心医院诊治的99例非ST段抬高型心肌梗死患者，根据入组顺序分成对照组（50例）和治疗组（49例）。对照组患者静脉滴注盐酸替罗非班氯化钠注射液，起始滴加速度为0.4μg/（kg∙min），0.5 h后以0.1μg/（kg∙min）维持，连续治疗72 h；治疗组在对照组基础上口服可达灵片，3片/次，3次/d。两组患者治疗2周。观察两组患者临床疗效，比较治疗前后两组患者SF-36、GRACE和VAS评分，血清心型脂肪酸结合蛋白（H-FABP）、和肽素和同型半胱氨酸（Hcy）水平及不良反应情况。结果 治疗后，治疗组总有效率为94.00%，明显高于对照组的75.51%（P<0.05）。治疗后，两组患者SF-36评分明显升高，而GRACE和VAS评分显著降低（P<0.05），且治疗组评分明显优于对照组（P<0.05）。治疗后，两组患者血清H-FABP、和肽素和Hcy水平均显著降低（P<0.05），且治疗组明显低于对照组（P<0.05）。治疗期间，治疗组不良反应发生率明显低于对照组（4.00%vs 18.37%，P<0.05）。结论 可达灵片联合替罗非班能够显著提升非ST段抬高型心肌梗死患者的临床治疗效果，改善患者的危险程度和生活质量，调节血清因子水平，安全性较高。

Objective To investigate the safety and efficacy of Kedaling Tablets combined with tirofiban in treatment of non-ST segment elevation myocardial infarction. Methods Patients (99 cases) with non-ST segment elevation myocardial infarction in Kaifeng Central Hospital from January 2020 to January 2021 were randomly divided into control (50 cases) and treatment (49 cases) groups. Patients in the control group were iv administered with Tirofiban Hydrochloride and Sodium Chloride Injection, the initial drop acceleration was 0.4 μg/(kg∙min), and maintained with 0.1 μg/(kg∙min) after 0.5 h, they were continuously treated for 72 h. Patients in the treatment group were po administered with Kedaling Tablets, 3 tablets/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, the scores of SF-36, GRACE, and VAS, the levels of serum H-FABP, copeptin, and Hcy, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the treatment group was 94.00%, which was significantly higher than 75.51% in the control group (P < 0.05). After treatment, the SF-36 score in two groups was significantly increased, while the scores of GRACE and VAS were significantly decreased (P < 0.05), and these scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the levels of serum H-FABP, peptidatin, and Hcy in two groups were significantly decreased (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). During the treatment, the incidence of adverse reactions in the treatment group was significantly lower than that in the control group (4.00% vs 18.37%, P < 0.05). Conclusion Kedaling Tablets combined with tirofiban can significantly improve the clinical therapeutic effect of patients with non-ST segment elevation myocardial infarction, which is safe to improve the risk degree and quality of life of patients and regulate the level of serum factors.

R972

河南省科技计划厅项目（豫科[2016]19号）