目的 探讨舒血宁注射液联合替罗非班治疗急性心肌梗死行急诊经皮冠状动脉介入（PCI）术患者的临床研究疗效。方法 选取2018年7月—2021年7月在芜湖市第二人民医院治疗的60例急性心肌梗死患者为研究对象，根据用药差别分为对照组和治疗组，每组各30例。对照组冠脉内注射盐酸替罗非班氯化钠注射液，急诊PCI术中给予10μg/kg，术后0.15 μg/（kg·min），持续静脉泵入24 h；在对照组基础上，治疗组术后静脉滴注舒血宁注射液，20 mg/次加入5%葡萄糖注射液250 mL中，1次/d。两组患者至少治疗3 d。观察两组患者临床疗效，比较治疗前后两组患者Sgarblssa评分、Selvester QRS评分、GQOLI-74评分和Barthel指数评分，心功能指标左心室射血分数（LVEF）、左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）、每搏输出量（SV）和二尖瓣舒张早期血流峰速度与二尖瓣环舒张早期运动峰速度之比（E/Em），血清可溶性P选择素（sP-sel）、单核细胞趋化蛋白-1（MCP-1）、补体C1q/肿瘤坏死抑制相关蛋白3（CTRP3）、去整合素-金属蛋酶9（ADAM9）、炎症细胞因子粒巨噬细胞集落刺激因子受体α（CSF2RA）、和肽素水平。结果 治疗后，对照组总有效率为80.00%，明显低于治疗组的100.00%（P<0.05）。治疗后，两组改良Sgarblssa评分和Selvester QRS评分明显下降，而GQOLI-74评分和Barthel指数评分均明显升高（P<0.05），并以治疗组积分改善最为明显（P<0.05）。治疗后，两组LVEF和SV明显升高，而LVEDD、LVESD和E/Em明显下降（P<0.05），并以治疗组心功能改善最为明显（P<0.05）。治疗后，两组患者血清sP-sel、MCP-1、ADAM9、CSF2RA、和肽素水平明显降低，而CTRP3水平明显升高（P<0.05），并以治疗组改善最为明显（P<0.05）。结论 舒血宁注射液联合替罗非班治疗急性心肌梗死行PCI术患者可有改善机体细胞因子水平，提高患者生活质量及日常生活能力，有效降低心肌梗死面积。

Objective To investigate the clinical efficacy of Shuxuening Injection combined with tirofiban in treatment of in treatment of acute myocardial infarction patients undergoing emergency percutaneous coronary intervention (PCI). Methods Patients (60 cases) with acute myocardial infarction in the Second People's Hospital of Wuhu from July 2018 to July 2021 were randomly divided into control and treatment group, and each group had 30 cases. Patients in the control group were intracoronary injection administered with Tirofiban Hydrochloride and Sodium Chloride Injection, 10 μg/kg during emergency PCI, postoperative 0.15 μg/(kg∙min), continuous intravenous pumping for 24 h. Patients in the treatment group were iv administered with Shuxuening Injection on the basis of the control group, 20 mg added into 5% glucose injection 250 mL, once daily. Patients in two groups were treated for at least 3 d. After treatment, the clinical evaluation was evaluated, the scores of Sgarblssa, Selvester QRS, GQOLI-74 and Barthel, cardiac function indexes of LVEF, SV, LVEDD, LVESD and E/Em, and the levels of serum sP-sel, MCP-1, ADAM9, CSF2RA, copeptin and CTRP3 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the control group was 80.005%, which was significantly lower than that in the treatment group (100.005%, P < 0.05). After treatment, the modified Sgarblssa score and Selvester QRS score were significantly decreased, while the GQOLI-74 score and Barthel index score were significantly increased in two groups (P < 0.05), especially in the treatment group (P < 0.05). After treatment, LVEF and SV were significantly increased, while LVEDD, LVESD and E/Em were significantly decreased in two groups (P < 0.05), and the improvement of cardiac function was the most obvious in the treatment group (P < 0.05). After treatment, the levels of serum sP-sel, MCP-1, ADAM9, CSF2RA and copeptin in the two groups were significantly decreased, while the level of CTRP3 were significantly increased (P < 0.05), especially in the treatment group (P < 0.05). Conclusion Shuxuening Injection combined with tirofiban can improve the level of cytokines in treatment of acute myocardial infarction patients undergoing emergency percutaneous coronary intervention, improve the quality of life and ability of daily living of patients, and effectively reduce the area of myocardial infarction.

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