目的 觀察注射用重組人尿激酶原聯(lián)合氯吡格雷治療急性ST段抬高型心肌梗死的臨床療效。方法 收集2016年1月—2016年12月商丘市中心醫(yī)院收治的急性ST段抬高型心肌梗死患者86例，隨機分為對照組和治療組，每組各43例。對照組口服硫酸氫氯吡格雷片，首次給予負荷量300 mg/次，1次/d，然后75 mg/次，1次/d；治療組在對照組的基礎上靜脈滴注注射用重組人尿激酶原，50 mg/次，先將20 mg加入生理鹽水10 mL，并且3 min內(nèi)靜脈推注完畢，然后30 mg加入生理鹽水90 mL，30 min內(nèi)靜脈滴注完畢。兩組患者均連續(xù)治療15 d。評價治療后兩組患者臨床療效，同時比較治療前后兩組心電圖改善情況和臨床癥狀、炎癥和心肌酶學指標水平。結(jié)果 治療后，對照組和治療組的總有效率分別為79.07%、93.02%，兩組比較差異具有統(tǒng)計學意義（P< 0.05）。治療后，對照組心電圖改善總有效率為76.74%，顯著低于治療組的90.70%，兩組比較差異具有統(tǒng)計學意義（P< 0.05）。治療后，兩組患者高敏C反應蛋白（hs-CRP）、白細胞介素-6（IL-6）、肌酸激酶（CK）和肌酸激酶MB型同工酶（CKMB）指標水平均顯著下降，同組比較差異具有統(tǒng)計學意義（P< 0.05）；且治療組患者hs-CRP、IL-6、CK和CKMB指標水平顯著低于對照組，兩組比較差異具有統(tǒng)計學意義（P< 0.05）。治療后，治療組患者胸痛緩解時間明顯比對照組更短，兩組比較差異具有統(tǒng)計學意義（P< 0.05）。結(jié)論 注射用重組人尿激酶原聯(lián)合氯吡格雷治療急性ST段抬高型心肌梗死可迅速改善臨床癥狀，且心電圖也得到顯著改善，具有一定的臨床推廣應用價值。

Objective To observe the clinical curative effect of Recombinant Human Prourokinase for injection combined with clopidogrel in treatment of acute ST-segment elevation myocardial infarction. Methods Patients (86 cases) with acute ST-segment elevation myocardial infarction in Shangqiu Central Hospital from January 2016 to December 2016 were randomly divided into control and treatment groups, and each group had 43 cases. Patients in the control group were po administered with Clopidogrel Hydrogen Sulphate Tablets, the first load dose was 300 mg/time, once daily, then 75 mg/time, and once daily. Patients in the treatment group were iv administered with Reocmbinant Human Prourokinase for injection on the basis of the control group, 50 mg/time, firstly, 20 mg added into normal saline 10 mL and intravenous bolus completion within 3 min, then 30 mg added into normal saline 90 mL and intravenous drip completion within 30 min. Patients in two groups were treated for 15 d. After treatment, clinical efficacy was evaluated, and the improvement of ECG and clinical symptoms, and inflammation and myocardial enzymes levels in two groups before and after treatment was compared. Results After treatment, the clinical efficacy in the control and treatment groups were 79.07% and 93.02%, respectively, and there were differences between two groups (P < 0.05). After treatment, the ECG improved efficiency in the control group was 76.74%, which was significantly lower than 90.70% in the treatment group, and there were differences between two groups (P < 0.05). After treatment, the hs-CRP, IL-6, CK and CKMB levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the hs-CRP, IL-6, CK and CKMB levels in the treatment group were significantly lower than that in the control group, with significant difference between two groups (P < 0.05). After treatment, the chest pain relief time in the treatment group was significantly shorter than that in the control group, with significant difference between two groups (P < 0.05). Conclusion Recombinant Human Prourokinase for injection combined with clopidogrel can quickly improve clinical symptoms in treatment of acute ST-segment elevation myocardial infarction, and ECG was also significantly improved, which has a certain clinical application value.