目的 探究心脈隆注射液聯(lián)合左卡尼汀注射液治療慢性心力衰竭的臨床療效。方法 選取2014年1月—2016年10月衡水市第四人民醫(yī)院收治的心力衰竭患者200例作為研究對象，根據(jù)患者入院順序分為對照組和治療組，每組各100例。對照組靜脈滴注左卡尼汀注射液，2 g加入到0.9%氯化鈉注射液50 mL中，滴速為20～40滴/min，1次/d。治療組在對照組治療基礎(chǔ)上靜脈滴注心脈隆注射液，5 mg/kg加入到0.9%氯化鈉注射液250 mL中，滴速為20～40滴/min，2次/d。所有患者均連續(xù)治療14 d。觀察兩組的臨床療效，比較兩組的心功能指標(biāo)、血清學(xué)指標(biāo)和6 min步行距離。結(jié)果 治療后，對照組和治療組的總有效率分別為82.00%、95.00%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組左室射血分?jǐn)?shù)（LVEE）和心指數(shù)（CI）均明顯升高，左心室舒張末期內(nèi)徑（LVEDD）、左心室收縮末期容積（LVESV）、左心室收縮末期內(nèi)徑（LVESD）均明顯下降，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)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(xué)意義（P<0.05）。治療后，兩組血清N末端腦鈉肽元（NT-proBNP）、血管緊張素Ⅱ（Ang Ⅱ）、血漿醛固酮（ALD）、血漿心鈉素（ANP）水平均顯著下降，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)明顯低于對照組，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組6 min步行距離顯著增加，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組6 min步行距離明顯長于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 心脈隆注射液聯(lián)合左卡尼汀注射液治療慢性心力衰竭具有較好的臨床療效，可改善心功能，調(diào)節(jié)血清學(xué)指標(biāo)，增加6 min步行距離，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical efficacy of Xinmailong Injection combined with Levocarnitine Injection in treatment of chronic heart failure. Methods Patients (100 cases) with chronic heart failure in the No. 4 People's Hospital of Hengshui from January 2014 to October 2016 were divided into control and treatment groups according to order of admission, and each group had 100 cases. Patients in the control group were iv administered with Levocarnitine Injection, 2 g added into normal saline 50 mL, the drop speed was 20-40 drops/min, once daily. Patients in the treatment group were iv administered with Xinmailong Injection on the basis of the control group, 5 mg/kg added into normal saline 250 mL, the drop speed was 20-40 drops/min, twice daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and cardiac function indexes, serological indexes, and 6 min walking distance in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 82.00% and 95.00%, respectively, and there was difference between two groups (P < 0.05). After treatment, LVEE and CI in two groups were significantly increased, but LVEDD, LVESV, and LVESD 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 better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the levels of NT-proBNP, Ang Ⅱ, ALD, and ANP 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, the 6 min walking distance in two groups were significantly increased, and the difference was significant in the same group (P < 0.05). And the observational indexes in the treatment group were longer than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Xinmailong Injection combined with Levocarnitine Injection has clinical curative effect in treatment of chronic heart failure, can improve cardiac function, regulate serological index, and increase 6 min walking distance, which has a certain clinical application value.

衡水市科技計劃項目（2016014041Z）