目的 探讨参松养心胶囊联合瑞替普酶治疗急性ST段抬高型心肌梗死的临床效果。方法 选取2016年1月—2019年1月郑州大学第一附属医院收治的84例急性ST段抬高型心肌梗死患者，随机分为对照组和治疗组，每组各42例。对照组给予注射用瑞替普酶，18 mg加入10 mL无菌注射用水，缓慢推注（时间＞2 min），30 min后重复1次上述操作。治疗组在对照组基础上口服参松养心胶囊，4粒/次，3次/d。两组均连续治疗14 d。观察两组的临床疗效，比较两组治疗前后心脏生物标志物、心脏超声指标、心肌梗死面积、血流变学相关参数和血清学指标的变化情况。结果 治疗后，对照组和治疗组的总有效率分别是76.2%、92.9%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组血清心肌肌钙蛋白I（cTnI）、肌酸激酶同工酶（CK-MB）、N末端B型利钠肽原（NT-proBNP）、心肌梗死面积均显著下降，而左室射血分数（LVEF）均显著增加，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组cTnI、CK-MB、NT-proBNP、心肌梗死面积显著低于对照组，而LVEF值高于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组全血黏度高切、低切（WHV和WLV）及血浆黏度（PV）值；纤维蛋白原（FIB）、D-二聚体（D-D）水平均较治疗前显著降低，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组这些血流变学相关参数显著低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组血清丙二醛（MDA）、超敏C反应蛋白（hs-CRP）水平较治疗前均显著降低，而超氧化物歧化酶（SOD）水平显著增高，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组MDA、hs-CRP低于对照组，而SOD水平高于对照组，两组比较差异具有统计学意义（P<0.05）。治疗期间，对照组主要不良心脏事件（MACE）发生率和不良反应发生率分别是26.2%、11.9%；治疗组MACE发生率和不良反应发生率分别9.5%、14.3%，两组比较差异无统计学意义。结论 参松养心胶囊联合瑞替普酶治疗急性ST段抬高型心肌梗死具有较好的临床疗效，能有效减轻患者心肌梗死程度，保护心功能，改善血流变学功能，拮抗机体氧化应激，减少心脏不良事件的发生，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Shensong Yangxin Capsules combined with reteplase in treatment of acute ST-segment elevation myocardial infarction. Methods Patients (84 cases) with acute ST-segment elevation myocardial infarction in First Affiliated Hospital of Zhengzhou University from January 2016 to January 2019 were randomly divided into control (42 cases) and treatment (42 cases) groups. Patients in the control group were given Reteplase for injection, 18 mg was added with 10 mL of sterile water for injection and injected slowly (> for 2 min). After 30 min, the above operation was repeated once. Patients in the treatment group were po administered with Shensong Yangxin Capsules, 4 grains/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the cardiac biomarkers, cardiac ultrasound indicators, myocardial infarction area, hemorheological parameters and serological indicators in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 76.2% and 92.9%, respectively, and there were differences between two groups (P<0.05). After treatment, cTnI, CK-MB, NT-proBNP, and myocardial infarction were significantly decreased, but LVEF were significantly increased, and there were differences in the same group (P<0.05). After treatment, cTnI, CK-MB, NT-proBNP, and myocardial infarction were significantly lower than those in the control group, but LVEF were significantly higher than that in the control group, and there were differences between two groups (P<0.05). After treatment, WHV, WLV, PV, FIB, D-D were significantly decreased, and there were differences in the same group (P<0.05). After treatment, those hemorheological parameters were significantly lower than those in the control group, and there were differences between two groups (P<0.05). After treatment, MDA and hs-CRP were significantly decreased, but SOD was significantly increased, and there were differences in the same group (P<0.05). After treatment, MDA and hs-CRP were significantly lower than those in the control group, but SOD was significantly higher than that in the control group, and there were differences between two groups (P<0.05). During the treatment period, the MACE incidence and adverse reactions in the control group were 26.2% and 11.9%, respectively, and MACE incidence and adverse reactions in the treatment group were 9.5% and 14.3%, and there was no statistically significant difference between two groups. Conclusion Shensong Yangxin Capsules combined with reteplase has significant effect in treatment of acute ST-segment elevation myocardial infarction, and can effectively reduce the myocardial infarction, and also can protect cardiac function, improve hemorheology function, and antagonize the oxidative stress, and reduce the adverse cardiac events occurrence, which has a certain clinical application value.