目的 探討注射用二丁酰環(huán)磷腺苷鈣聯(lián)合左西孟旦注射液治療慢性心力衰竭的臨床療效。方法 選取2016年5月—2017年5月在洛陽市第三人民醫(yī)院進(jìn)行治療的慢性心力衰竭患者92例作為研究對(duì)象，根據(jù)隨機(jī)數(shù)字表將患者分為對(duì)照組和治療組，每組各46例。對(duì)照組靜脈滴注左西孟旦注射液，10 mL加入到5%葡萄糖注射液500 mL中，1次/d。治療組在對(duì)照組基礎(chǔ)上靜脈滴注注射用二丁酰環(huán)磷腺苷鈣，40 mg加入到5%葡萄糖注射液250 mL中，1次/d。兩組患者均連續(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)、血清細(xì)胞因子和6 min步行試驗(yàn)（6 WMT）。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為80.43%、95.65%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組左心室射血分?jǐn)?shù)（LVEF）、每分鐘排血量（CO）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）明顯下降，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組心功能指標(biāo)明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組血清β內(nèi)啡肽（β-EP）、氨末端腦利鈉肽前體（NT-proBNP）、肌鈣蛋白T（cTnT）水平顯著降低，類胰島素生長(zhǎng)因子1（IGF-1）、心肌營(yíng)養(yǎng)素1（CT-1）水平顯著升高，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組血清細(xì)胞因子明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組6 WMT距離均顯著增加，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組6 WMT距離明顯長(zhǎng)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 注射用二丁酰環(huán)磷腺苷鈣聯(lián)合左西孟旦注射液治療慢性心力衰竭具有較好的臨床療效，可改善患者心功能，調(diào)節(jié)血清NT-proBNP、β-EP、cTnT、IGF-1、CT-1水平，提高患者運(yùn)動(dòng)耐量，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To explore the clinical efficacy of Calcii Dibutyry-ladenosini Cyclophosphas for injection combined with Levosimendan Injection in treatment of chronic heart failure. Methods Patients (92 cases) with chronic heart failure in Luoyang Third People's Hospital from May 2016 to May 2017 were randomly divided into control and treatment groups, and each group had 46 cases. Patients in the control group were iv administered with Levosimendan Injection, 10 mg added into 5% glucose solution 500 mL, once daily. Patients in the treatment group were iv administered with Calcii Dibutyry-ladenosini Cyclophosphas for injection on the basis of the control group, 40 mg added into 5% glucose solution 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and cardiac function indexes, serum cytokines, 6 WMT in two group were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 80.43% and 95.65%, respectively, and there was difference between two groups (P < 0.05). After treatment, LVEF and CO 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 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, β-EP, NT-proBNP, and cTnT levels in two groups were significantly decreased, but IGF-1 and CT-1 levels in two groups were significantly increased, and the difference was statistically significant in the same group (P <0.05). And serum cytokines 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 distance of 6 WMT in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the distance of 6 WMT in the treatment group was significantly longer than that in the control group, with significant difference between two groups (P < 0.05). Conclusion Calcii Dibutyry-ladenosini Cyclophosphas for injection combined with Levosimendan Injection has clinical curative effect in treatment of chronic heart failure, can improve the cardiac function of patients, regulate the levels of NT-proBNP, β-EP, IGF-1, and CT-1, and improve the exercise tolerance of patients, which has a certain clinical application value.