目的 探討利腦心片聯(lián)合重組人尿激酶原治療急性心肌梗死的臨床療效。方法 選取2018年10月—2020年10月在延安市人民醫(yī)院治療的144例急性心肌梗死患者，根據(jù)隨機數(shù)字法分為對照組（72例）和治療組（72例）。對照組患者靜脈滴注注射重組人尿激酶原，50 mg/次，先將20 mg溶于10 mL生理鹽水，3 min內(nèi)靜推完畢，余30 mg溶于100 mL生理鹽水，30 min內(nèi)靜脈滴注完畢，1次/d。治療組患者在對照組的基礎(chǔ)上飯后口服利腦心片，3片/次，3次/d。兩組患者治療7 d。觀察兩組患者臨床療效，比較治療前后兩組患者臨床癥狀好轉(zhuǎn)時間，肌酸激酶同工酶（CK-MB）、乳酸脫氫酶（LDH）和肌鈣蛋白T（TnT）指標(biāo)，及血清炎性因子白細(xì)胞介素6（IL-6）、白細(xì)胞介素8（IL-8）、C反應(yīng)蛋白（CRP）和腫瘤壞死因子-α（TNF-α）水平。結(jié)果 治療后，治療組患者總有效率為98.61%，明顯高于對照組的87.51%（P<0.05）。治療后，治療組患者臨床癥狀好轉(zhuǎn)時間均早于對照組（P<0.05）。治療后，兩組患者CK-MB、LDH、TnT及血清炎性因子IL-6、IL-8、CRP、TNF-α水平均明顯低于對照組（P<0.05）；治療后，治療組這些指標(biāo)改善優(yōu)于對照組（P<0.05）。結(jié)論 利腦心片聯(lián)合注射用重組人尿激酶原治療急性心肌梗死效果顯著，臨床癥狀緩解較快，有效改善冠狀動脈血流量，降低心肌炎性反應(yīng)，藥物不良反應(yīng)較小。

Objective To investigate the clinical study of Linaoxin Tablets combined with recombinant human prourokinase in treatment of acute myocardial infarction. Methods Patients (144 cases) with acute myocardial infarction in Yanan People's Hospital from October 2018 to October 2020 were randomly divided into control (72 cases) and treatment (72 cases) group. Patients in the control group were iv administered with Recombinant Human Prourokinase for injection, 50 mg/time, 20 mg dissolved into normal saline 10 mL, and completed within 3 min, then 30 mg dissolved into normal saline 100 mL, intravenous drip completed within 30 min, once daily. Patients in the treatment group were po administered with Linaoxin Tablets, 3 tablets/time, three times daily. Patients in two groups were treated for 7 d. After treatment, the clinical evaluation was evaluated, the improvement time of clinical symptoms, the indexes of CK-MB, LDH, TnT, the levels of serum inflammatory factor IL-6, IL-8, CRP, and TNF-α in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 98.61%, which was significantly higher than that of the control group (87.51%) (P < 0.05). After treatment, the relief time of clinical symptom in the treatment group was earlier than that in the control group (P < 0.05). After treatment, the improvement time of clinical symptoms in treatment group was earlier than that in control group (P < 0.05). After treatment, the levels of CK-MB, LDH, TnT and serum inflammatory factors IL-6, IL-8, CRP and TNF-α in two groups were significantly lower than those in control group (P< 0.05). After treatment, the improvement of these indexes in the treatment group was better than the control group (P < 0.05). Conclusion The effect of Linaoxin Tablets combined with recombinant human prourokinase in treatment of acute myocardial infarction is obvious, the clinical symptoms are relieved quickly, the coronary blood flow is improved effectively, the myocardial inflammatory reaction is reduced, and the adverse drug reaction is less.

R972

國家自然科學(xué)基金資助項目（81670229）