目的 分析稳心颗粒联合氯吡格雷治疗急性ST段抬高型心肌梗死的临床疗效。方法 选取2021年8月—2023年6月首都医科大学附属北京友谊医院收治的116例急性ST段抬高型心肌梗死患者，按随机数字表法分为对照组和治疗组，每组各58例。对照组口服硫酸氢氯吡格雷片，300 mg/次，1次/d，连服7 d后按75 mg/次，1次/d。治疗组在此基础上开水冲服稳心颗粒，1袋/次，3次/d。两组连续治疗4周。比较两组临床疗效、心脏损伤标志物、超声心动图指标及血清淀粉样蛋白A（SAA）、白细胞介素-33（IL-33）、血管紧张素1-7[Ang（1-7）]水平。统计两组主要不良心脏事件（MACE）情况。结果 治疗后，治疗组总有效率是93.10%，显著高于对照组的79.31%（P＜0.05）。治疗后，两组血清B型利钠肽（BNP）、肌酸激酶同工酶（CK-MB）、心肌肌钙蛋白I（cTnI）、可溶性生长刺激表达基因2蛋白（sST2）水平均显著降低（P＜0.05）；以治疗组降低更显著（P＜0.05）。治疗后，两组左室射血分数（LVEF）均显著增加，而左心房容积指数（LAVI）和左心房前后径（LAD）均显著降低（P＜0.05）；以治疗组改善更显著（P＜0.05）。治疗后，两组血清SAA、IL-33、Ang（1-7）水平均显著下降（P＜0.05）；以治疗组降低更显著（P＜0.05）。治疗后，治疗组MACE发生率是5.17%，显著低于对照组的17.24%（P＜0.05）。结论 稳心颗粒联合氯吡格雷治疗急性ST段抬高型心肌梗疗效及安全性较高，患者心功能得到有效保护，心肌损害及机体炎症程度明显减轻，心脏不良事件减少，值得临床推广应用。

Objective To analyze the clinical efficacy of Wenxin Granules combined with clopidogrel in treatment of acute ST segment elevated myocardial infarction. Methods A total of 116 patients with acute ST-segment elevation myocardial infarction admitted to Beijing Friendship Hospital Affiliated to Capital Medical University from August 2021 to June 2023 were selected and divided into control group and treatment group according to random number table method, with 58 cases in each group. Patients in the control group were po administered with Clopidogrel Bisulfate Tablets, 300 mg/time, once daily, after 7 d of continuous administration, 75 mg/d, once daily. Patients in the treatment group were po administered with Wenxin granules on the basis of control group, 1 bag/time, 3 times daily. Both groups were treated continuously for 4 weeks. The clinical efficacy, markers of heart injury, echocardiogram and serum levels of amyloid A (SAA), interleukin-33 (IL-33) and angiotensin 1-7[Ang (1-7)] were compared between two groups. Major adverse cardiac events (MACE) were measured in two groups. Results After treatment, the total effective rate of treatment group was 93.10%, which was significantly higher than 79.31% of control group ( P < 0.05). After treatment, the serum levels of B-type natriuretic peptide (BNP), creatine kinase isoenzyme (CK-MB), cardiac troponin I (cTnI), and soluble growth stimulation expression gene 2 protein (sST2) in 2 groups were significantly decreased (P < 0.05). The decrease was more significant in treatment group (P <0.05). After treatment, left ventricular ejection fraction (LVEF) was significantly increased, but left atrial volume index (LAVI) and left atrial anterior and posterior diameter (LAD) were significantly decreased in both groups (P < 0.05). The improvement was more significant in treatment group (P < 0.05). After treatment, serum levels of SAA, IL-33, and Ang (1-7) in 2 groups were significantly decreased (P < 0.05). The decrease was more significant in treatment group (P < 0.05). After treatment, the incidence of MACE in treatment group was 5.17%, which was significantly lower than that in control group (17.24%, P < 0.05). Conclusion Wenxin Granules combined with clopidogrel has high efficacy and safety in treatment of acute ST segment elevated myocardial infarction, and can effectively protects the cardiac function of patients, significantly reduces the degree of myocardial damage and body inflammation, and reduces cardiac adverse events, which is worthy of clinical promotion and application.

R972

北京市“青苗”计划项目（QML20181906）