目的 探讨脉血康胶囊联合替罗非班治疗老年急性冠状动脉综合征的临床疗效。方法 选取2022年3月—2024年1月武汉市武昌医院收治的急性冠状动脉综合征患者94例，随机分为对照组（47例）和治疗组（47例）。对照组静脉滴注盐酸替罗非班注射液，溶于生理盐水，浓度为50 μg/mL，1次/d。在对照组的基础上，治疗组口服脉血康胶囊，4粒/次，3次/d。两组患者治疗4周。观察两组患者临床疗效，比较治疗前后两组患者血管性血友病因子（vWF）、血管内皮生长因子（VEGF）、内皮素-1（ET-1）、循环系统内皮细胞（CEC）、三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白（LDL-C）、高密度脂蛋白（HDL-C）、白细胞介素-18（IL-18）、胱抑素C（CysC）、白细胞介素-6（IL-6）和超敏C反应蛋白（hs-CRP）指标水平。结果 治疗后，治疗组的总有效率（91.49%）明显高于对照组（74.47%，P＜0.05）。治疗后，两组患者vWF、VEGF、ET-1、CEC、TG、TC、LDL-C、IL-18、CysC、IL-6、hs-CRP指标水平明显降低，而HDL-C水平明显升高（P＜0.05），且与对照组比较，治疗后治疗组的上述指标水平明显低于对照组（P＜0.05）。结论 脉血康胶囊联合替罗非班治疗老年急性冠状动脉综合征效果确切，可有效改善患者缺血程度及相关症状，同时能减弱机体炎性反应状态。

Objective To explore the clinical efficacy of Maixuekang Capsules combined with tirofiban in treatment of elderly acute coronary syndrome. Methods Patients (94 cases) with elderly acute coronary syndrome in Wuhan Wuchang Hospital from March 2022 to January 2024 were randomly divided into control (47 cases) and treatment (47 cases) group. Patients in the control group were iv administered with Tirofiban Hydrochloride Injection dissolved in normal saline, 50 μg/mL, once daily. Patients in the treatment group were po administered with Maixuekang Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluations were evaluated, the levels of vWF, VEGF, ET-1, CEC, TG, TC, LDL-C, HDL-C, IL-18, CysC-C, IL-6 and hs-CRP in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group (91.49%) was significantly higher than that in the control group (74.47%, P < 0.05). After treatment, the levels of vWF, VEGF, ET-1, CEC, TG, TC, LDL-C, IL-18, CysC, IL-6, and hs-CRP were significantly reduced in two groups, while the levels of HDL-C were significantly increased (P < 0.05), and compared with the control group, the levels of these indicators in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Maixuekang Capsules combined with tirofiban in treatment of elderly acute coronary syndrome has a definite effect. It can effectively improve the degree of ischemia and related symptoms of patients, and at the same time weaken the inflammatory reaction.

R972

湖北省自然科学基金资助项目(2022CFC022)