目的 探討托拉塞米聯(lián)合培哚普利治療心力衰竭的臨床療效。方法 收集2016年1月-2017年4月在西安醫(yī)學院第二附屬醫(yī)院進行治療的心力衰竭患者82例，隨機分為對照組（41例）和治療組（41例）。對照組患者口服精氨酸培哚普利片，起始劑量為2 mg/次，1次/d，2周后以4 mg/次維持治療，1次/d。治療組在對照組的基礎(chǔ)上靜脈滴注托拉塞米注射液，初始劑量為10 mg加入250 mL生理鹽水，1次/d，根據(jù)療效可增至20 mg/d，最大劑量為40 mg/d。兩組患者均治療14 d。評價兩組患者臨床療效，同時比較治療前后兩組患者心功能和血清學指標。結(jié)果 治療后，對照組和治療組總有效率分別為75.61%、92.68%，兩組比較差異具有統(tǒng)計學意義（P<0.05）。治療后，兩組患者左心室收縮末內(nèi)徑（LVEDD）、左心室收縮末容量（LVESV）和左心室舒張末內(nèi)徑（LVESD）均明顯降低，左心室射血分數(shù)（LVEE）則明顯升高，同組比較差異具有統(tǒng)計學意義（P<0.05）；且治療組心功能指標改善程度顯著優(yōu)于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。治療后，兩組患者血清氨基末端腦利鈉肽前體（NT-proBNP）、白介素-1β（IL-1β）、細胞間黏附分子-1（ICAM-1）和超敏C反應(yīng)蛋白（hs-CRP）水平均明顯降低，同組比較差異具有統(tǒng)計學意義（P<0.05）；且治療組血清學指標比對照組降低更顯著，兩組比較差異具有統(tǒng)計學意義（P<0.05）。結(jié)論 托拉塞米聯(lián)合培哚普利片治療心力衰竭可明顯改善患者心功能，降低機體炎癥反應(yīng)，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical curative effect of torasemide combined with perindopril in treatment of heart failure. Methods Patients (82 cases) with heart failure in the Second Affiliated Hospital of Xi'an Medical College from January 2016 to April 2017 were randomly divided into control (41 cases) and treatment (41 cases) groups. Patients in the control group were po administered with Perindopril Arginine Tablets, the initial dosage was 2 mg/time, once daily, then the maintain dosage was 2 mg/time after two weeks, once daily. Patients in the treatment group were iv administered with Torsemide Injection on the basis of the control group, the initial dosage was 10 mg added into 250 mL normal saline, once daily, which was increased to 20 mg/d according to the efficacy, and the maximum dose was 40 mg/d. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the cardiac function indexes and serological markers in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 75.61% and 92.68%, respectively, and there were differences between two groups (P<0.05). After treatment, the LVEDD, LVESV and LVESD in two groups were significantly decreased, LVEE was significantly increased, and the difference was statistically significant in the same group (P<0.05). And the cardiac function indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of hs-CRP, NT-proBNP, ICAM-1 and IL-1β in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). These serological markers in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Torasemide combined with perindopril can significantly improve heart function in treatment of heart failure, and reduce the inflammatory reactions, which has a certain clinical application value.