目的 探讨益心康泰胶囊联合替罗非班治疗不稳定型心绞痛的临床疗效。方法 选择2020年6月—2021年12月河南科技大学第一附属医院收治的136例不稳定型心绞痛患者，采用随机数字表法分为对照组（68例）和治疗组（68例）。对照组静脉注射盐酸替罗非班氯化钠注射液，起始30min滴注速率为0.4μg/(kg∙min)，输注量完成后，继续以0.1μg/(kg∙min)的速率维持滴注，1次/d。在对照组的基础上，治疗组口服益心康泰胶囊，2粒/次，3次/d。两组患者应用药物7d。观察两组患者临床疗效，比较治疗前后两组患者症状改善时间，心功能指标左室舒张期容积（EDV）、左室射血分数（LVEF）、心脏每搏输出量（SV）和左心室舒张末期压（LVSP），血清白细胞介素-6（IL-6）、血管细胞黏附因子（sVCAM-1）、基质金属蛋白酶-9（MMP-9）和血清内皮素-1（ET-1）水平，及不良反应。结果 治疗后，治疗组总有效率（98.53%）明显高于对照组（85.29%，P＜0.05）。治疗后，治疗组患者临床症状改善时间均明显早于对照组（P＜0.05）。治疗后，两组患者LVEF、SV指标均明显升高，而LVSP、EDV指标均显著降低（P＜0.05）；且治疗组LVEF、SV指标均高于对照组，LVSP、EDV指标均低于对照组（P＜0.05）。治疗后，两组患者血清IL-6、MMP-9、sVCAM-1、ET-1水平明显下降（P＜0.05）；且治疗组的IL-6、MMP-9、sVCAM-1、ET-1水平均明显低于对照组（P＜0.05）。治疗组不良反应发生率明显低于对照组（P＜0.05）。结论 替罗非班与益心康泰胶囊联合治疗不稳定型心绞痛疗效确切，可明显改善心肌缺血状态，减弱炎症反应。

Objective To investigate the clinical efficacy of Yixin Kangtai Capsules combined with tirofiban in treatment of unstable angina pectoris. Methods Patients (136 cases) with unstable angina pectoris in the First Affiliated Hospital of Henan University of Science and Technology from June 2020 to December 2021 were divided into control (68 cases) and treatment (68 cases) group according to the random number table method. Patients in the control group were iv administered with Tirofiban Hydrochloride and Sodium Chloride Injection, the initial drip rate of 30 min is 0.4 μg/(kg∙min), after the infusion volume was completed, continued to maintain the drip at a rate of 0.1 μg/(kg∙min), once daily. Patients in the treatment group po administered with Yixin Kangtai Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 7 d. After treatment, the clinical evaluation was evaluated, the improvement time of symptom, the cardiac function indexes LVEF, SV, LVSP, and EDV, the levels of serum factor IL-6, MMP-9, sVCAM-1, and ET-1, and adverse reaction in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group (98.53%) was significantly higher than that of the control group (85.29%, P<0.05). After treatment, the improvement time of clinical symptoms in the treatment group was significantly earlier than that in the control group (P<0.05). After treatment, LVEF and SV indexes were significantly higher in two groups, while LVSP and EDV indexes were significantly decreased (P<0.05). LVEF and SV indexes in treatment group were higher than those in control group, LVSP and EDV indexes were lower than those in control group (P<0.05). After treatment, serum levels of IL-6, MMP-9, sVCAM-1 and ET-1 in two groups were significantly decreased (P<0.05). The levels of IL-6, MMP-9, sVCAM-1 and ET-1 in the treatment group were significantly lower than those in the control group (P<0.05). The incidence of adverse reactions in the treatment group was significantly lower than that in the control group (P<0.05). Conclusion The curative effect of tirofiban combined with Yixin Kangtai Capsules in treatment of unstable angina pectoris is definite, can obviously improve the state of myocardial ischemia and weaken the inflammatory reaction.

R972

河南省医学科技攻关计划（联合共建）项目（LHGJ20190576）