目的 探討參麥注射液聯(lián)合注射用環(huán)磷腺苷和注射用重組人腦利鈉肽治療慢性肺源性心臟病心力衰竭的臨床療效。方法 選取2015年10月—2016年10月上海交通大學附屬胸科醫(yī)院收治的慢性肺源性心臟病心力衰竭患者112例，將所有患者隨機分為對照組和治療組，每組各56例。對照組靜脈滴注注射用環(huán)磷腺苷，40 mg加入到5%葡萄糖注射液或生理鹽水100 mL中，1次/d，連續(xù)治療3周。且靜脈滴注注射用重組人腦利鈉肽，首次負荷劑量1.5 μg/kg，之后劑量為7.5 ng/（kg·min），連續(xù)治療3 d。治療組在對照組基礎上靜脈滴注參麥注射液，50 mL加入到5%葡萄糖注射液或生理鹽水250 mL中，1次/d，連續(xù)治療3周。觀察兩組的臨床療效，比較兩組的血清D-二聚體（D-D）、N末端B型鈉尿肽原（NT-proBNP）、心肌肌鈣蛋白I（CTnI）、血流動力學和動脈血氣指標情況。結果 治療后，對照組和治療組的總有效率分別為78.6%、94.6%，兩組比較差異有統(tǒng)計學意義（P< 0.05）。治療后，兩組D-D、NT-proBNP和CTnI水平均顯著下降，同組治療前后比較差異有統(tǒng)計學意義（P< 0.05）；且治療組這些觀察指標明顯低于對照組，兩組比較差異具有統(tǒng)計學意義（P< 0.05）。治療后，兩組右房壓（RAP）、右室壓（RVP）、平均肺動脈壓（mPAP）和二氧化碳分壓（pCO₂）均顯著下降，而氧分壓（pO₂）顯著升高，同組治療前后比較差異有統(tǒng)計學意義（P< 0.05）；且治療組這些觀察指標的改善程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學意義（P< 0.05）。結論 參麥注射液聯(lián)合注射用環(huán)磷腺苷和注射用重組人腦利鈉肽治療慢性肺源性心臟病心力衰竭具有較好的臨床療效，能降低肺動脈高壓，改善心肺功能，具有一定的臨床推廣應用價值。

Objective To investigate the effects of Shenmai Injection combined with Adenosine Cyclphosphate for injection and Recombinant Human Brain Natriuretic Peptide for injection in treatment of chronic pulmonary heart disease with heart failure. Methods Patients (112 cases) with chronic pulmonary heart disease with heart failure in Shanghai Chest Hospital Affiliated to Shanghai Jiaotong University from October 2015 to October 2016 were randomly divided into control and treatment groups, and each group had 56 cases. Patients in the control group were iv administered with Adenosine Cyclphosphate for injection, 40 mg added into 5% glucose solution (or normal saline) 100 mL, once daily and treated for 3 weeks. And patients in the control group were also iv administered with Recombinant Human Brain Natriuretic Peptide for injection, first load dose of 1.5 μg/kg, then dose of 7.5 μg/(kg·min), continuous treatment for 3 d. Patients in the treatment group were iv administered with Shenmai Injection on the basis of the control group, 50 mL added into 5% glucose solution (or normal saline) 250 mL, once daily and treated for 3 weeks. After treatment, the clinical efficacies were evaluated, and D-dimer (D-D), NT-proBNP, CTnI, hemodynamics, and arterial blood gas indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 78.6% and 94.6%, respectively, and there was difference between two groups (P < 0.05). After treatment, the levels of D-D, NT-proBNP, and CTnI in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, RAR, RVP, mPAP, and pCO₂ in two groups were significantly decreased, but the pO₂ in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Shenmai Injection combined with Adenosine Cyclphosphate for injection and Recombinant Human Brain Natriuretic Peptide for injection has clinical curative effect in treatment of chronic pulmonary heart disease with heart failure, can decrease high pressure in the pulmonary artery, and improve heart and lung function, which has a certain clinical application value.