目的 探討益心康泰膠囊聯(lián)合替羅非班治療不穩(wěn)定型心絞痛的臨床療效。方法 選擇2020年6月—2021年12月河南科技大學(xué)第一附屬醫(yī)院收治的136例不穩(wěn)定型心絞痛患者，采用隨機數(shù)字表法分為對照組（68例）和治療組（68例）。對照組靜脈注射鹽酸替羅非班氯化鈉注射液，起始30min滴注速率為0.4μg/(kg∙min)，輸注量完成后，繼續(xù)以0.1μg/(kg∙min)的速率維持滴注，1次/d。在對照組的基礎(chǔ)上，治療組口服益心康泰膠囊，2粒/次，3次/d。兩組患者應(yīng)用藥物7d。觀察兩組患者臨床療效，比較治療前后兩組患者癥狀改善時間，心功能指標(biāo)左室舒張期容積（EDV）、左室射血分?jǐn)?shù)（LVEF）、心臟每搏輸出量（SV）和左心室舒張末期壓（LVSP），血清白細(xì)胞介素-6（IL-6）、血管細(xì)胞黏附因子（sVCAM-1）、基質(zhì)金屬蛋白酶-9（MMP-9）和血清內(nèi)皮素-1（ET-1）水平，及不良反應(yīng)。結(jié)果 治療后，治療組總有效率（98.53%）明顯高于對照組（85.29%，P＜0.05）。治療后，治療組患者臨床癥狀改善時間均明顯早于對照組（P＜0.05）。治療后，兩組患者LVEF、SV指標(biāo)均明顯升高，而LVSP、EDV指標(biāo)均顯著降低（P＜0.05）；且治療組LVEF、SV指標(biāo)均高于對照組，LVSP、EDV指標(biāo)均低于對照組（P＜0.05）。治療后，兩組患者血清IL-6、MMP-9、sVCAM-1、ET-1水平明顯下降（P＜0.05）；且治療組的IL-6、MMP-9、sVCAM-1、ET-1水平均明顯低于對照組（P＜0.05）。治療組不良反應(yīng)發(fā)生率明顯低于對照組（P＜0.05）。結(jié)論 替羅非班與益心康泰膠囊聯(lián)合治療不穩(wěn)定型心絞痛療效確切，可明顯改善心肌缺血狀態(tài)，減弱炎癥反應(yīng)。

Objective To investigate the clinical efficacy of Yixin Kangtai Capsules combined with tirofiban in treatment of unstable angina pectoris. Methods Patients (136 cases) with unstable angina pectoris in the First Affiliated Hospital of Henan University of Science and Technology from June 2020 to December 2021 were divided into control (68 cases) and treatment (68 cases) group according to the random number table method. Patients in the control group were iv administered with Tirofiban Hydrochloride and Sodium Chloride Injection, the initial drip rate of 30 min is 0.4 μg/(kg∙min), after the infusion volume was completed, continued to maintain the drip at a rate of 0.1 μg/(kg∙min), once daily. Patients in the treatment group po administered with Yixin Kangtai Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 7 d. After treatment, the clinical evaluation was evaluated, the improvement time of symptom, the cardiac function indexes LVEF, SV, LVSP, and EDV, the levels of serum factor IL-6, MMP-9, sVCAM-1, and ET-1, and adverse reaction in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group (98.53%) was significantly higher than that of the control group (85.29%, P<0.05). After treatment, the improvement time of clinical symptoms in the treatment group was significantly earlier than that in the control group (P<0.05). After treatment, LVEF and SV indexes were significantly higher in two groups, while LVSP and EDV indexes were significantly decreased (P<0.05). LVEF and SV indexes in treatment group were higher than those in control group, LVSP and EDV indexes were lower than those in control group (P<0.05). After treatment, serum levels of IL-6, MMP-9, sVCAM-1 and ET-1 in two groups were significantly decreased (P<0.05). The levels of IL-6, MMP-9, sVCAM-1 and ET-1 in the treatment group were significantly lower than those in the control group (P<0.05). The incidence of adverse reactions in the treatment group was significantly lower than that in the control group (P<0.05). Conclusion The curative effect of tirofiban combined with Yixin Kangtai Capsules in treatment of unstable angina pectoris is definite, can obviously improve the state of myocardial ischemia and weaken the inflammatory reaction.

R972

河南省醫(yī)學(xué)科技攻關(guān)計劃（聯(lián)合共建）項目（LHGJ20190576）