目的 探討通脈養(yǎng)心丸聯(lián)合鹽酸替羅非班治療不穩(wěn)定型心絞痛的臨床療效。方法 回顧性分析2018年10月-2020年10月在駐馬店市中心醫(yī)院治療的122例不穩(wěn)定型心絞痛患者臨床資料，根據治療方案的差異分成對照組（61例）和治療組（61例）。對照組給予鹽酸替羅非班氯化鈉注射液，初始計量0.4 μg/（kg·min），用藥30 min后，繼續(xù)以0.1 μg/（kg·min）的速率維持滴注。治療組在對照組基礎上口服通脈養(yǎng)心丸，40丸/次，2次/d。兩組均治療10 d。觀察兩組的臨床療效，比較兩組治療前后心功能指標、血清學指標和凝血指標的變化情況。結果 治療后，治療組治療的總有效率是98.36%，遠高于對照組（81.97%，P<0.05）。經治療，兩組患者心輸出量（CO）、每搏量（SV）、射血分數(shù)（EF）均顯著提高（P<0.05）；治療后，治療組患者心功能指標顯著高于對照組（P<0.05）。經治療，兩組患者血清半乳糖凝集素-3（Gal-3）、血清Ⅰ型膠原羧基端吡啶并啉交聯(lián)肽（ICTP）、可溶性生長刺激基因表達蛋白2（sST2）、人可溶性細胞黏附分子（sICAM-1）、血清炎癥脂肪細胞因子五聚素3（PTX-3）水平均顯著下降（P<0.05）；且治療后治療組血清學指標低于對照組（P<0.05）。經治療，兩組患者纖維蛋白原（FIB）、D-二聚體（D-D）水平均顯著下降（P<0.05）；且治療后，治療組FIB、D-D低于對照組（P<0.05）。結論 通脈養(yǎng)心丸聯(lián)合鹽酸替羅非班治療不穩(wěn)定型心絞痛可有效提高患者臨床療效，改善患者心功能和血清學指標，有利于調節(jié)凝血指標，有一定的臨床推廣應用價值。

Objective To investigate the effect of Tongmai Yangxin Pills combined with tirofiban in treatment of unstable angina pectoris. Methods Retrospective analysis was performed on the clinical data of 122 patients with unstable angina treated in Zhumadian Central Hospital from October 2018 to October 2020. The patients were divided into control group (61 cases) and treatment group (61 cases) according to the difference of treatment. The control group was given Tirofiban Hydrochloride Sodium Chloride Injection, and the initial dosage was 0.4 μg/(kg·min). After 30 min, the infusion was continued at the rate of 0.1 μg/(kg·min). Patients in the treatment group were po administered with Tongmai Yangxin Pills on the basis of the control group, 40 pills/time, twice daily. Patients in two groups were treated for 10 d. The clinical efficacy of the two groups was observed, and the changes of cardiac function, serology and coagulation indexes before and after treatment were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 98.36%, much higher than that of the control group (81.97%, P<0.05). After treatment, CO, SV and EF were significantly increased in both groups (P<0.05). After treatment, cardiac function indexes of patients in the treatment group were significantly higher than those in the control group (P<0.05). After treatment, two groups of patients with serum Gal-3, ICTP, sST2, sICAM-1, PTX-3, levels were significantly decreased (P<0.05); After treatment, serological indexes of the treatment group were lower than those of the control group (P<0.05). After treatment, the levels of FIB and D-D in both groups were significantly decreased (P<0.05). After treatment, FIB and D-D in the treatment group were lower than those in the control group (P<0.05). Conclusion Tongmai Yangxin Pills combined with tirofiban can effectively improve the clinical efficacy in treatment of unstable angina pectoris, and can improve cardiac function and serological indexes, and is beneficial to regulate blood coagulation indexes, which has certain clinical application value.

R972

河北省醫(yī)學科學研究項目[冀工辦科教（2017）3號]