摘要目的:研究冠心宁片联合抗血小板治疗急性冠状动脉综合征（ACS）的效果及安全性。方法:选取树兰（杭州）医院2021年1月至2021年12月收治的ACS患者120例为研究对象，采用随机数字表法分为对照组和研究组各60例。对照组采用氯吡格雷和阿司匹林治疗，研究组采用氯吡格雷和阿司匹林联合冠心宁片治疗。两组均治疗3个月，在治疗前后记录并比较两组患者的血脂［高密度脂蛋白胆固醇（HDL-C）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）］水平、C反应蛋白（CRP）、肿瘤坏死因子α（TNF-α）、血清内皮素1（ET-1）及血管内皮生长因子（VEGF）水平与不良反应发生率。结果:治疗后，两组LDL-C、TC、TG均低于治疗前，HDL-C高于治疗前（均 P < 0.05）；对照组TC［（4.36±1.01）mmol/L］、LDL-C［（3.02±0.28）mmol/L］、TG［（1.98±0.12）mmol/L］均高于研究组［（3.98±1.05）mmol/L、（2.52±0.42）mmol/L、（1.58±0.23）mmol/L］，差异均有统计学意义（ t=-2.02、-7.67、-11.94，均 P < 0.05），HDL-C［（1.26±0.08）mmol/L］低于研究组［（2.36±0.16）mmol/L］，差异有统计学意义（ t=47.63， P < 0.001）。治疗后，对照组CRP［（5.62±0.56）mg/L］、ET-1［（86.24±12.68）pg/L］均显著高于研究组［（4.32±0.82）mg/L、（75.26±12.46）pg/L］，差异均有统计学意义（ t=-10.14、-4.78，均 P < 0.001），TNF-α［（5.62±0.56）mg/L］、VEGF［（76.28±13.52）pg/L］均显著低于研究组［（8.76±1.06）mg/L、（86.32±13.46）pg/L］，差异均有统计学意义（ t=20.23、4.08，均 P < 0.001）。两组不良反应发生率相比，研究组［5.00%（3/60）］低于对照组［8.33%（5/60）］，但差异无统计学意义（χ 2=-0.54， P > 0.05）。 结论:冠心宁片联合抗血小板治疗ACS的效果显著，且安全性高，具有临床应用价值。

abstractsObjective:To investigate the effect and safety of Guanxinning tablets combined with antiplatelet therapy on acute coronary syndrome. Methods:A total of 120 patients with acute coronary syndrome who received treatment in Shulan (Hangzhou) Hospital from January 2021 to December 2021 were included in this study. They were randomly divided into a control group and a study group ( n = 60/group). The control group was treated with antiplatelet drugs clopidogrel and aspirin. The study group was treated with clopidogrel, aspirin and Guanxinning tablets in combination. All patients were treated for 3 months. The levels of blood lipids (high-density lipoprotein cholesterol, total cholesterol, triglyceride, low-density lipoprotein cholesterol), C-reactive protein, tumor necrosis factor-α, endothelin-1, and vascular endothelial growth factor measured before and after treatment as well as the incidence of adverse reactions were compared between the two groups. Results:After treatment, serum levels of low-density lipoprotein cholesterol, total cholesterol, and triglyceride in each group were significantly decreased compared with those measured before treatment (all P < 0.05). After treatment, serum level of high-density lipoprotein cholesterol in each group was significantly increased compared with that measured before treatment ( P < 0.05). After treatment, serum levels of total cholesterol, low-density lipoprotein cholesterol, and triglyceride in the control group were (4.36 ± 1.01) mmol/L, (3.02 ± 0.28) mmol/L, and (1.98 ± 0.12) mmol/L respectively which were significantly higher than (3.98 ± 1.05) mmol/L, (2.52 ± 0.42) mmol/L, (1.58 ± 0.23) mmol/L in the study group ( t = -2.02, -7.67, -11.94, all P <0.05). Serum level of high-density lipoprotein cholesterol in the control group was significantly lower than that in the study group [(1.26 ± 0.08) mmol/L vs. (2.36 ± 0.16) mmol/L, t = 47.63, P < 0.001). After treatment, serum levels of C-reactive protein and endothelin-1 in the control group were (5.62 ± 0.56) mg/L and (86.24 ± 12.68) pg/L, respectively, which were significantly higher than (4.32 ± 0.82) mg/L and (75.26 ± 12.46) pg/L in the study group, ( t = -10.14, -4.78, both P < 0.001). After treatment, serum levels of tumor necrosis factor-α and vascular endothelial growth factor in the control group were (5.62 ± 0.56) mg/L and (76.28 ± 13.52) pg/L, which were significantly lower than (8.76 ± 1.06) mg/L and (86.32 ± 13.46) pg/L in the study group ( t = 20.23, 4.08, both P < 0.05). The incidence of adverse reactions in the study group was significantly lower than that in the control group [5.00% (3/60) vs. 8.33% (5/60), χ2 = -0.54, P > 0.05). Conclusion:Guanxinning tablets combined with antiplatelet has a remarkable therapeutic effect on acute coronary syndrome. It is highly safe and has a clinical application value.