目的 探討曲美他嗪聯(lián)合氯吡格雷對急性心肌梗死患者心功能和血清巨噬細胞遷移抑制因子（MIF）、白細胞介素-10（IL-10）水平的影響。方法 選取2017年5月—2019年5月在武漢市紅十字會醫(yī)院治療的老年急性心肌梗死患者96例作為研究對象，將患者隨機分為對照組和觀察組，每組各48例。對照組口服硫酸氫氯吡格雷片，75 mg/次，1次/d。觀察組在對照組基礎上口服鹽酸曲美他嗪片，20 mg/次，3次/d。兩組均治療1個月。比較兩組患者的左室射血分數(shù)（LVEF）、心輸出量（CO）及左室舒張末期內(nèi)徑（LVEDD）等心功能指標水平、MIF、IL-10水平及藥物安全性。結果 治療后，兩組LVEF、CO水平顯著升高，LVEDD水平顯著降低，同組治療前后比較差異具有統(tǒng)計學意義（P<0.05）；治療后，觀察組LVEF、CO水平顯著高于對照組，而觀察LVEDD水平顯著低于對照組（P<0.05）。兩組治療后血清MIF和血清IL-10水平均顯著低于治療前，同組治療前后比較差異具有統(tǒng)計學意義（P<0.05）；觀察組治療后血清MIF和IL-10水平均顯著低于對照組（P<0.05）。觀察組治療后心律失常、心源性休克及出血發(fā)生率顯著低于對照組（P<0.05）。結論 曲美他嗪聯(lián)合氯吡格雷用于急性心肌梗死患者中能改善患者心功能，降低MIF和IL-10水平，且不增加不良反應及不良心臟事件的發(fā)生率，具有一定的臨床推廣應用價值。

Objective To investigate the effect of trimotaziaine combined with clopidogrel on cardiac function and serum MI) and IL-10 levels in patients with acute myocardial infarction. Methods A total of 96 elderly patients with acute myocardial infarction treated in the Wuhan Red Cross Hospital from May 2017 to May 2019 were selected as the research objects and randomly divided into control group and observation group, with 48 patients in each group. Patients in the control group were po administered with Clopidogrel Hydrogen Sulphate Tablets on the basis of conventional treatment, 75 mg/time, once daily. Patients in the observation group were po administered with Trimetazidine Dihydrochloride Tablets on the basis of the control group, 20 mg/time, three times daily. Both groups were treated for 1 month. After treatment, the cardiac parameter levels of LVEF, CO, LVEDD, the levels of MIF, IL-10, and drug safety between two groups were compared. After treatment, LVEF and CO levels in two groups were significantly increased, while the LVEDD levels were significantly decreased, the difference in the same group before and after treatment was statistically significant (P<0.05). Results After treatment, LVEF and CO levels in the observation group were significantly higher than those in the control group, while the LVEDD levels in the observation group were significantly lower than those in the control group, with statistically significant differences between the two groups (P<0.05). After treatment, the serum levels of MIF and IL-10 in two groups were significantly lower than those before treatment, and the difference in the same group before and after treatment was statistically significant (P<0.05). After treatment, the serum levels of MIF and IL-10 in the observation group were significantly lower than those in the control group, with statistically significant differences between the two groups (P<0.05). After treatment, the incidence of arrhythmia, cardiogenic shock, and bleeding in the observation group were significantly lower than those in the control group (P<0.05). Conclusion Trimotaziaine combined with clopidogrel in treatment of acute myocardial infarction can improve cardiac function, reduce the levels of MIF and IL-10, without increasing the incidence of adverse reactions and adverse cardiac events, which has certain clinical application value.

R972

湖北省衛(wèi)計委資助項目（W2017M1059）