目的 探討血必凈注射液聯(lián)合替格瑞洛和阿司匹林治療急性冠脈綜合征（ACS）的臨床療效。方法 選取2015年1月—2016年1月在石家莊市第二醫(yī)院心內(nèi)科接受治療的86例ACS患者為研究對象，根據(jù)治療方法的不同分為對照組（43例）和治療組（43例）。所有患者均給予擴(kuò)張冠狀動脈、降血脂和抗凝血等常規(guī)治療。對照組口服替格瑞洛片，首日劑量180mg/次，1次/d，次日劑量90 mg/次，2次/d；同時口服阿司匹林腸溶片，首日劑量300 mg/次，次日劑量150 mg/次，均為1次/d。治療組在對照組基礎(chǔ)上靜脈滴注血必凈注射液，50 mL加入生理鹽水250 mL，2次/d。兩組患者均治療14 d。觀察兩組的臨床療效，比較兩組治療前后血清炎性因子、血小板凝集率（PAR）和心功能指標(biāo)的變化情況以及心血管不良事件發(fā)生率。結(jié)果 治療后對照組總有效率為81.40%，顯著低于治療組的95.35%，兩組總有效率比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后兩組患者血清超敏C-反應(yīng)蛋白（hs-CRP）、白細(xì)胞介素-17（IL-17）、IL-6和基質(zhì)金屬蛋白酶-9（MMP-9）較治療前均顯著降低（P<0.05），且治療組這些血清炎性因子的降低程度優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后兩組患者PAR低于治療前（P<0.05），且治療組降低的更明顯（P<0.05）。治療后兩組患者的舒張早期二尖瓣血流速度與舒張晚期二尖瓣血流速度比值（E/A）、左心室舒張末期內(nèi)徑（LVEDD）和左心射血分?jǐn)?shù)（LVEF）水平較治療前均顯著升高（P<0.05），且治療組這些心功能指標(biāo)的改善程度優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后對照組和治療組的不良反應(yīng)發(fā)生率分別為30.23%和16.28%，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 血必凈注射液聯(lián)合替格瑞洛和阿司匹林治療ACS療效顯著，可明顯降低血小板聚集率和炎癥反應(yīng)，改善心功能。

Objective To evaluate the clinical efficacies of Xuebijing Injection combined with ticagrelor and aspirin in treatment of acute coronary syndrome (ACS). Methods Patients (86 cases) with ACS in the Department of Cardiology of Shijiazhuang Second Hospital from January 2015 to January 2016 were enrolled in this study. According to the different treatments, they were divided into treatment group (43 cases) and control group (43 cases). All patients were given conventional treatment with coronary artery dilatation, lipid lowering, and anti-coagulation, etc. The patients in the control group were po administered with Ticagrelor Tablets, the first dosage was 180 mg, once daily, and the dosage for the next day was 180 mg/time, twice daily. And they were po administered with Aspirin Enteric-coated Tablets, the first dosage was 300 mg/time, and the second dosage was 150 mg/time, once daily. The patients in the treatment group were iv administered with Xuebijing Injection on the basis of the control group, 50 mL added into normal saline 250 mL, twice daily. The patients in two groups were treated for 14 d. After treatment, clinical efficacies were evaluated. And serum inflammatory factors, PAR, cardiac function index and incidence of cardiovascular adverse events in two groups were compared. Results After treatment, clinical efficacy in the control groups was 81.40%, which was significantly lower than that (95.35%) in the treatment group, and there were significant differences between two groups (P<0.05). After treatment, hs-CRP, IL-17, IL-6 and MMP-9 in two groups were obviously decreased (P<0.05), the changes of serum inflammatory factors in the treatment group were better than those in the control group, with significant difference between two groups (P<0.05). After treatment, PAR in two groups was significantly decreased (P<0.05), and the treatment group had a more obvious decrease (P<0.05). After treatment, E/A, LVEDD and LVEF in the two groups were significantly increased (P<0.05), and these cardiac function indexes in the treatment group were better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the incidences of cardiovascular adverse events in the control and treatment groups were 30.23% and 16.28%, respectively, and the difference was statistically significant between two groups (P<0.05). Conclusion Xuebijing Injection combined with ticagrelor and aspirin in treatment of ACS has a good clinical efficacy, can significantly decrease PAR and inflammatory reaction, and improve the cardiac function.