目的:探讨安心通络方联合替罗非班对急性心肌梗死PCI术后血浆s ICAM-1及心肌微循环的影响。方法:选取行PCI手术治疗的122例急性心肌梗死患者为研究对象,随机分为对照组及治疗组,各61例。两组均予标准PCI术前、术中、术后处理,治疗组再予安心通络方干预。观察两组治疗前后血浆中s ICAM-1水平、心肌微循环(3级获得率、LVEF)、生活质量(SF-36)、中医证候积分的变化,记录不良反应事件,评估临床疗效。结果:总有效率对照组为85.2%,治疗组为96.7%,组间比较,差异有统计学意义(P<0.05)。两组术后1 d、术后1周、术后4周患者血浆中s ICAM-1水平呈逐渐下降趋势,两组组内不同时间点比较,差异有统计学意义(P<0.05);其中治疗组术后1周、术后4周患者血浆中s ICAM-1水平低于同期对照组(P<0.05)。24 h后3级获得率对照组为31.1%,治疗组为34.4%,组间差异无统计学意义(P>0.05);两组术后4周患者LVEF水平高于同组术后1周(P<0.05),术后4周治疗组LVEF水平高于同期对照组(P<0.05)。术后4周两组患者生理功能、生理职能、躯体疼痛、一般健康状况、活力、社会功能、情感职能、精神健康评分均高于同组术后1周(P<0.05);术后4周治疗组患者生理功能、生理职能、躯体疼痛、一般健康状况、活力、社会功能、情感职能、精神健康评分均高于同期对照组(P<0.05)。术后4周两组患者中医证候积分低于同组术后1周(P<0.05);术后4周治疗组患者中医证候积分低于同期对照(P<0.05)。两组均未出现非致死性心肌梗死、心源性死亡病例;其中对照组再次血管重建术3例(4.9%),治疗组1例(1.7%),两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:安心通络方联合替罗非班治疗急性心肌梗死PCI术后患者,临床疗效显著,安全性高,能有效降低患者血浆s ICAM-1水平,改善患者心肌微循环,提高患者生活质量。 Objective: To investigate the effect of Anshin Tongluo combined with tirofiban on plasma s ICAM-1 and myocardial microcirculation after PCI in patients with acute myocardial infarction. Methods: A total of 122 patients with acute myocardial infarction treated with PCI were selected as study subjects and randomly divided into control group and treatment group, each with 61 cases. Both groups were given standard PCI preoperative, intraoperative and postoperative treatment, the treatment group and then relief Xin Tongluo Fang intervention. The levels of s ICAM-1, myocardial microcirculation (Grade 3, LVEF), quality of life (SF-36) and TCM syndrome score were observed before and after treatment. The adverse reactions were recorded and the clinical efficacy was evaluated. Results: The total effective rate was 85.2% in the control group and 96.7% in the treatment group. There was significant difference between the two groups (P <0.05). The levels of s ICAM-1 in plasma decreased gradually on the 1st day after operation, one week after operation, and four weeks after operation. The difference was statistically significant (P <0.05) between the two groups at different time points The levels of s ICAM-1 in the plasma of the patients in the treatment group were lower than those in the control group at 1 week and 4 weeks after operation (P <0.05). After 24 hours, the grade 3 acquisition rate was 31.1% in the control group and 34.4% in the treatment group, with no significant difference between the two groups (P> 0.05). The LVEF level in the two groups after 4 weeks was higher than that in the same group after 1 week P <0.05). The LVEF level of the 4 weeks after operation in the treatment group was higher than that in the control group (P <0.05). At 4 weeks after operation, the physiological function, physical function, physical pain, general health status, vitality, social function, emotional function and mental health score of the two groups were all higher than those of the same group one week after operation (P <0.05) Physiological function, physical function, physical pain, general health status, vitality, social function, emotional function and mental health score of the treatment group were higher than those of the control group (P <0.05). The scores of TCM syndromes in the two groups were lower than those in the same group one week after operation (P <0.05). The scores of TCM syndromes in the four weeks after operation were lower than those in the same period (P <0.05). No non-fatal myocardial infarction and no cardiac death occurred in both groups. Among them, 3 cases (4.9%) in the control group underwent revascularization again and 1 case (1.7%) in the treatment group, the incidence of adverse reactions was no significant difference between the two groups Statistical significance (P> 0.05). Conclusion: The combination of Yixintongluo Recipe and tirofiban in patients with acute myocardial infarction after PCI has significant clinical effect and high safety. It can effectively reduce the level of plasma ICAM-1, improve myocardial microcirculation and improve the quality of life of patients.