目的 探讨替罗非班联合氯吡格雷治疗急性心肌梗死的临床疗效和安全性。方法 选自南阳市第二人民医院于2018年3月—2019年6月收治的86例急性心肌梗死患者，按照治疗方式的不同分为对照组和治疗组，每组各43例。对照组患者口服硫酸氢氯吡格雷片，首次用药量为300 mg/次，之后缩减至75 mg/次，1次/d。治疗组患者在对照组的基础上静脉滴注盐酸替罗非班注射液0.4 μg/（kg·min），30 min后，调整为0.1 μg/（kg·min）。两组患者均以7 d为1个疗程，连续治疗2个疗程。观察两组的临床疗效，比较两组心功能指标、血清炎性因子水平的变化情况。结果 治疗后，治疗组总有效率是95.3%，显著高于对照组的83.7%（P<0.05）。治疗后，两组心功能与治疗前相比均有所降低（P<0.05），治疗组低于对照组（P<0.05）。治疗后，两组患者血清炎性因子水平均有所下降（P<0.05），且治疗组下降情况优于对照组（P<0.05）。治疗组不良反应发生率是9.3%，显著低于对照组的28.0%（P<0.05）。结论 替罗非班联合氯吡格雷治疗急性心肌梗死临床效果显著，可改善炎性因子水平及心功能状况，不良反应发生率低，具有一定的临床推广应用价值。

Objective To investigate the clinical effect and safety of tirofeban combined with clopidogrel in the treatment of acute myocardial infarction. Methods A total of 86 patients with acute myocardial infarction admitted to Nanyang Second People's Hospital from March 2018 to June 2019 were selected and divided into control group and treatment group according to different treatment methods, with 43 patients in each group. Patients in the control group were po administered with Clopidogrel Hydrogen Sulphate Tablets, the first dosage was 300 mg/time, and then the dosage was reduced to 75 mg/time, once daily. Patients in the treatment group were iv administered with Tirofiban Hydrochloride Injection, 0.4 μg/kg·min on the basis of the control group, which was adjusted to 0.1 μg/kg·min after 30 min. Patients in both groups were treated for 7 days as one course of treatment, and they were treated for 2 courses consecutively. The clinical efficacy of the two groups was observed, and the changes of cardiac function indicators and serum inflammatory factors were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 95.3%, significantly higher than that of the control group (83.7%, P<0.05). After treatment, cardiac function of both groups was improved compared with that before treatment (P<0.05), and the treatment group was better than the control group (P<0.05). After treatment, the level of serum inflammatory factors decreased in both groups (P<0.05), and the reduction in the treatment group was better than that in the control group (P<0.05). The incidence of adverse reactions in the treatment group was 9.3%, significantly lower than that in the control group (28.0%, P<0.05). Conclusion Tirofiban combined with clopidogrel has a significant clinical effect in the treatment of acute myocardial infarction, and can improve the level of inflammatory factors and cardiac function, with low incidence of adverse reactions, which has a certain clinical application value.

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