目的 探讨养心定悸胶囊联合阿托伐他汀钙片治疗急性心肌梗死的临床疗效。方法 选取2019年10月—2021年5月天津市宁河区医院收治的总共82例急性心肌梗死患者，按照随机数字表法将所有患者分为对照组和治疗组，每组各41例。对照组口服阿托伐他汀钙片，20 mg/次，1次/d。治疗组在对照组基础上口服养心定悸胶囊，6粒/次，2次/d。两组患者共治疗4周。观察两组的临床疗效，比较两组患者治疗前后心肌梗死面积的变化、心功能指标[左心室射血分数（LVEF）、心输出量（CO）]以及血清脂质指标脂蛋白（a）[Lp （a）]、载脂蛋白[Apo （a）]、一氧化氮（NO）、内皮素-1（ET-1）水平。结果 治疗后，治疗组患者的总有效率（87.80%）明显高于对照组的总有效率（68.29%）（P<0.05）。治疗后，两组的心肌梗死面积显著缩小（P<0.05），且治疗组心肌梗死面积缩小更明显（P<0.05）。治疗后，两组的LVEF、CO明显升高（P<0.05），治疗组LVEF、CO较对照组升高更明显（P<0.05）。治疗后，两组的Lp （a）、Apo （a）、ET-1水平明显降低，NO水平明显升高（P<0.05）；治疗组的Lp （a）、Apo （a）、ET-1水平低于对照组，NO水平高于对照组，差异有统计学意义（P<0.05）。结论 养心定悸胶囊联合阿托伐他汀钙片可提高急性心肌梗死的疗效，能缩小心肌梗死面积，提高心功能，改善血脂代谢水平，且安全性良好。

Objective To investigate the clinical efficacy of Yangxin Dingji Capsules combined with Atorvastatin Calcium Tablets in treatment of acute myocardial infarction. Methods Patients (82 cases) with acute myocardial infarction in Tianjin Ninghe Hospital from October 2019 to May 2021 were randomly divided into control and treatment groups, and each group had 41 cases. Patients in the control group were po administered with Atorvastatin Calcium Tablets, 20 mg/time, once daily. Patients in the treatment group were po administered with Yangxin Dingji Capsules on the basis of the control group, 6 grains/time, twice daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and the myocardial infarction area, LVEF and CO of cardiac function indexes, and the serum levels of LP(a), Apo(a), NO, and ET-1 in two groups were compared. Results After treatment, the total effective rate of the treatment group (87.80%) was significantly higher than that of the control group (68.29%) (P<0.05). After treatment, the myocardial infarction area in two groups were significantly decreased (P<0.05), and the myocardial infarction area in the treatment group was significantly smaller than that in the control group (P<0.05). After treatment, LVEF and CO in two groups were significantly increased (P<0.05), and LVEF and CO in the treatment group was significantly higher than that in the control group (P<0.05). After treatment, the levels of LP(a), Apo(a), and ET-1 in two groups were significantly decreased, but levels of NO in two groups were significantly increased (P<0.05). The levels of LP(a), Apo(a) and ET-1 in the treatment group were lower than those in the control group, but level of NO in the treatment group was higher than those in the control group (P<0.05). Conclusion Yangxin Dingji Capsules combined with Atorvastatin Calcium Tablets can improve the curative effect of acute myocardial infarction, reduce the area of myocardial infarction, improve cardiac function, and improve the level of blood lipid metabolism, with good safety.

R972

河北省中医药管理局科研计划项目（2019311）