目的 考察通心络胶囊联合注射用尿激酶治疗急性ST段抬高型心肌梗死的临床疗效。方法 选取2017年6月-2019年12月在天津市第三中心医院分院治疗的120例急性ST段抬高型心肌梗死患者，所有患者随机分为对照组和治疗组，每组各60例。对照组患者给予注射用尿激酶，将注射用尿激酶溶于生理盐水，按6 000 U/min冠状动脉内连续滴注2 h。治疗组在对照组基础上口服通心络胶囊，3粒/次，3次/d。两组患者持续治疗2周。观察两组患者临床疗效，比较两组的心功能指标、血流变学指标、血清学指标、血清炎性因子水平。结果 治疗后，治疗组总有效率96.67%显著较对照组的83.33%高（P<0.05）。治疗后，两组患者左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）显著降低，左室射血分数（LVEF）显著升高（P<0.05），且治疗组左心功能指标改善较多（P<0.05）。治疗后，两组患者血清血浆黏度（PV）、纤维蛋白原（FIB）、D-二聚体（D-D）水平显著降低（P<0.05）；且治疗组血液流变学指标水平降低较明显（P<0.05）。治疗后，两组血清N末端B型钠尿肽原（NT-proBNP）和肌钙蛋白T（cTnT）水平显著降低（P<0.05）；并且治疗组血清NT-proBNP和cTnT水平降低较明显（P<0.05）。治疗后，两组血清超敏C-反应蛋白（hs-CRP）水平显著降低（P<0.05）；并且治疗组血清hs-CRP水平降低较多（P<0.05）。结论 通心络胶囊联合注射用尿激酶治疗急性ST段抬高型心肌梗死具有较好的治疗效果，能够改善心功能，降低血液流变学指标和血清NT-proBNP、cTnT、hs-CRP水平。

Objective To study the efficacy of Tongxinluo Capsules combined with Urokinase for injection in treatment of acute ST-segment elevation myocardial infarction. Methods Patients (120 cases) with acute ST-segment elevation myocardial infarction in Branch of Tianjin Third Central Hospital from June 2017 to December 2019 were randomly divided into control and treatment groups, and each group had 60 cases. Patients in the control group were given Urokinase for injection, and the drug was dissolved in normal saline and continuously injected into the coronary artery at 6 000 U/min for 2 h. Patients in the treatment group were po administered with Tongxinluo Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and cardiac function index, hemorheology index, serological index, and serum inflammatory factor level in two groups were compared. Results After treatment, the total effective rate of 96.67% in the treatment group was significantly higher than 83.33% in the control group (P < 0.05). After treatment, LVEDD and LVESD in two groups were significantly decreased, but LVEF in two groups was significantly increased (P < 0.05), and the indexes of left ventricular function in the treatment group were improved more than those in the control group (P < 0.05). After treatment, the levels of PV, FIB, and D-D in two groups were significantly decreased (P < 0.05), and the levels of hemorheology in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the levels of NT-proBNP and cTnT in two groups were significantly decreased (P < 0.05), and the levels of serum NT-proBNP and cTnT in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of hs-CRP in two groups were significantly decreased (P < 0.05), and the serum level of hs-CRP in the treatment group decreased more than that in the control group (P < 0.05). Conclusion Tongxinluo Capsules combined with Urokinase for injection has clinical curative effect in treatment of acute ST-segment elevation myocardial infarction, can improve cardiac function, reduce hemorheology indexes and the serum levels of NT-proBNP, cTnT, hs-CRP.

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