目的 探討注射用血塞通聯(lián)合阿替普酶治療急性心肌梗死的療效及對(duì)同型半胱氨酸（Hcy）、血栓調(diào)節(jié)蛋白（TM）、纖溶酶-α 2PI復(fù)合物（PIC）和血栓負(fù)荷的影響。方法 選取龍口市人民醫(yī)院2018年7月—2019年6月收治的100例急性心肌梗死患者作為研究對(duì)象，根據(jù)隨機(jī)數(shù)字表法將患者分為對(duì)照組和觀察組，每組各50例。對(duì)照組給予注射用阿替普酶，首次靜脈推注20 mg，然后在30 min內(nèi)靜脈滴注50 mg，然后在60 min后靜脈滴注30 mg，每日總劑量100 mg。觀察組在對(duì)照組患者治療的基礎(chǔ)上靜脈滴注注射用血塞通，0.4 g溶于250 mL葡萄糖注射液稀釋，1次/d。兩組連續(xù)治療15 d。觀察兩組患者的臨床療效，比較兩組左心室射血分?jǐn)?shù)（LVEF）、心排血量（CO）、舒張?jiān)缙诹魉俜逯?舒張晚期流速峰值（E/A值）、血栓負(fù)荷程度、Hcy、TM、PIC和梗死面積。結(jié)果 觀察組患者治療后的總有效率為94.00%，明顯高于對(duì)照組的80.00%（P<0.05）。兩組治療后的LVEF、CO、E/A均顯著升高（P<0.05）；觀察組治療后的LVEF、CO、E/A均顯著高于對(duì)照組（P<0.05）。兩組治療后的血栓評(píng)分顯著降低（P<0.05），且觀察組降低的更明顯（P<0.05）。兩組治療后的Hcy、TM、PIC水平均顯著降低（P<0.05）；觀察組治療后的Hcy、TM、PIC均低于對(duì)照組（P<0.05）。治療后，兩組患者心肌梗死面積均顯著減少（P<0.05），且觀察組治療后的梗死面積顯著低于對(duì)照組（P<0.05）。結(jié)論 注射用血塞通聯(lián)合阿替普酶可提高急性心肌梗死的療效，降低hcy、TM、PIC的水平，減輕血栓負(fù)荷程度，提高心功能，具有一定的臨床研究?jī)r(jià)值。

Objective To investigate the effect of Xuesaitong for injection combined with alteplase on Hcy, TM, PIC, and thrombus load in patients with acute myocardial infarction. Methods A total of 100 patients with acute myocardial infarction admitted to Longkou People's Hospital from July 2018 to June 2019 were selected as the research objects. According to the random number table method, the patients were divided into control group and observation group, with 50 patients in each group. Patients in the control group was given Alteplase for Injection, first intravenous injection of 20 mg, then intravenous infusion of 50 mg within 30 min, and then intravenous infusion of 30 mg for 60 min later, with a total daily dose of 100 mg. Patients in the observation group were iv administered with Xuesaitong for injection on the basis of control group, 0.4 g was dissolved in 250 mL glucose injection for dilution, once daily. The two groups were treated consecutively for 15 d. After treatment, the clinical efficacy in two groups were observed, and the levels of LVEF, CO, E/A value, thrombotic load, Hcy, TM, PIC, and infarct size were compared. Results The total effective rate after treatment in the observation group was 94.00%, which was significantly higher than 80.00% in the control group (P<0.05). After treatment, LVEF, CO, and E/A in two groups were significantly increased (P<0.05). After treatment, LVEF, CO, and E/A in the observation group were significantly higher than those in the control group (P<0.05). The thrombus score after treatment was significantly reduced in two groups (P<0.05), and the reduction was more significant in the observation group (P<0.05). After treatment, Hcy, TM, and PIC levels in two groups were significantly decreased (P<0.05). And the levels of Hcy, TM and PIC in the observation group were lower than those in the control group (P<0.05). After treatment, the myocardial infarction area in both groups was significantly reduced (P<0.05), and the infarct area of the observation group was significantly lower than that of the control group (P<0.05). Conclusion Xuesaitong for injection combined with alteplase can improve the efficacy of acute myocardial infarction, reduce the levels of HCY, TM and PIC, reduce the thrombus load, and improve cardiac function, which has certain clinical research value.

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