目的 探讨注射用血塞通联合阿替普酶治疗急性心肌梗死的疗效及对同型半胱氨酸（Hcy）、血栓调节蛋白（TM）、纤溶酶-α 2PI复合物（PIC）和血栓负荷的影响。方法 选取龙口市人民医院2018年7月—2019年6月收治的100例急性心肌梗死患者作为研究对象，根据随机数字表法将患者分为对照组和观察组，每组各50例。对照组给予注射用阿替普酶，首次静脉推注20 mg，然后在30 min内静脉滴注50 mg，然后在60 min后静脉滴注30 mg，每日总剂量100 mg。观察组在对照组患者治疗的基础上静脉滴注注射用血塞通，0.4 g溶于250 mL葡萄糖注射液稀释，1次/d。两组连续治疗15 d。观察两组患者的临床疗效，比较两组左心室射血分数（LVEF）、心排血量（CO）、舒张早期流速峰值/舒张晚期流速峰值（E/A值）、血栓负荷程度、Hcy、TM、PIC和梗死面积。结果 观察组患者治疗后的总有效率为94.00%，明显高于对照组的80.00%（P<0.05）。两组治疗后的LVEF、CO、E/A均显著升高（P<0.05）；观察组治疗后的LVEF、CO、E/A均显著高于对照组（P<0.05）。两组治疗后的血栓评分显著降低（P<0.05），且观察组降低的更明显（P<0.05）。两组治疗后的Hcy、TM、PIC水平均显著降低（P<0.05）；观察组治疗后的Hcy、TM、PIC均低于对照组（P<0.05）。治疗后，两组患者心肌梗死面积均显著减少（P<0.05），且观察组治疗后的梗死面积显著低于对照组（P<0.05）。结论 注射用血塞通联合阿替普酶可提高急性心肌梗死的疗效，降低hcy、TM、PIC的水平，减轻血栓负荷程度，提高心功能，具有一定的临床研究价值。

Objective To investigate the effect of Xuesaitong for injection combined with alteplase on Hcy, TM, PIC, and thrombus load in patients with acute myocardial infarction. Methods A total of 100 patients with acute myocardial infarction admitted to Longkou People's Hospital from July 2018 to June 2019 were selected as the research objects. According to the random number table method, the patients were divided into control group and observation group, with 50 patients in each group. Patients in the control group was given Alteplase for Injection, first intravenous injection of 20 mg, then intravenous infusion of 50 mg within 30 min, and then intravenous infusion of 30 mg for 60 min later, with a total daily dose of 100 mg. Patients in the observation group were iv administered with Xuesaitong for injection on the basis of control group, 0.4 g was dissolved in 250 mL glucose injection for dilution, once daily. The two groups were treated consecutively for 15 d. After treatment, the clinical efficacy in two groups were observed, and the levels of LVEF, CO, E/A value, thrombotic load, Hcy, TM, PIC, and infarct size were compared. Results The total effective rate after treatment in the observation group was 94.00%, which was significantly higher than 80.00% in the control group (P<0.05). After treatment, LVEF, CO, and E/A in two groups were significantly increased (P<0.05). After treatment, LVEF, CO, and E/A in the observation group were significantly higher than those in the control group (P<0.05). The thrombus score after treatment was significantly reduced in two groups (P<0.05), and the reduction was more significant in the observation group (P<0.05). After treatment, Hcy, TM, and PIC levels in two groups were significantly decreased (P<0.05). And the levels of Hcy, TM and PIC in the observation group were lower than those in the control group (P<0.05). After treatment, the myocardial infarction area in both groups was significantly reduced (P<0.05), and the infarct area of the observation group was significantly lower than that of the control group (P<0.05). Conclusion Xuesaitong for injection combined with alteplase can improve the efficacy of acute myocardial infarction, reduce the levels of HCY, TM and PIC, reduce the thrombus load, and improve cardiac function, which has certain clinical research value.

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