目的 研究甲磺酸酚妥拉明注射液聯(lián)合注射用左卡尼汀治療慢性肺源性心臟病的臨床療效。方法 選取2018年6月-2019年6月天津市北辰區(qū)中醫(yī)醫(yī)院收治的100例慢性肺源性心臟病患者為研究對象，將所有患者隨機分為對照組和治療組，每組各50例。對照組患者靜脈滴注注射用左卡尼汀，3 g/次，溶于250 mL 0.9%氯化鈉注射液中，1次/d；治療組患者在對照組基礎上靜脈滴注甲磺酸酚妥拉明注射液，10 mg/次，溶于250 mL 0.9%氯化鈉注射液中，1次/d。兩組患者持續(xù)治療10 d。觀察兩組的臨床療效，比較兩組心功能指標、肺功能指標、血氣指標及平均肺動脈壓（mPAP）、D-二聚體（D-D）、心肌肌鈣蛋白I（CTnI）和N-末端腦鈉肽前體（NT-proBNP）水平。結(jié)果 治療后，對照組和治療組總有效率分別為86.00%、96.00%，治療組總有效率顯著較高（P<0.05）。治療后，兩組患者左室舒張末期內(nèi)徑（LVEDD）和左房舒張末期內(nèi)徑（LAEDD）水平明顯下降，左室射血分數(shù)（LVEF）水平明顯升高（P<0.05）；并且治療組心功能指標改善較多（P<0.05）。治療后，兩組患者第一秒用力呼氣容積（FEV1）、最大呼氣流量（PEF）和用力肺活量（FVC）水平顯著升高（P<0.05）；并且治療組肺功能指標升高較多（P<0.05）。治療后，兩組患者二氧化碳分壓（pCO₂）和mPAP水平顯著降低，氧分壓（pO₂）水平顯著升高（P<0.05）；并且治療組血氣指標和mPAP改善程度較大（P<0.05）。治療后，兩組患者D-D、CTnI和NT-proBNP水平顯著降低（P<0.05）；并且治療組降低較多（P<0.05）。結(jié)論 甲磺酸酚妥拉明注射液聯(lián)合注射用左卡尼汀治療慢性肺源性心臟病具有較好的療效，可以改善肺功能和心功能，安全性較高，值得在臨床上推廣應用。

Objective To study the efficacy of Phentolamine Mesylate Injection combined with Levocarnitine for injection in treatment of chronic pulmonary heart disease. Methods Patients (100 cases) with chronic pulmonary heart disease in Tianjin Beichen District Hospital of Traditional Chinese Medicine from June 2018 to June 2019 were randomly divided into control and treatment groups, and each group had 50 cases. Patients in the control group were iv administered with Levocarnitine for injection, 3 g added into 0.9% sodium chloride injection solution 250 mL, once daily. Patients in the treatment group were iv administered with Phentolamine Mesylate Injection on the basis of the control group, 10 mg added into 0.9% sodium chloride injection solution 250 mL, once daily. Patients in two groups were treated for 10 d. After treatment, the clinical efficacies were evaluated, and heart function indexes, pulmonary function indexes, the levels of pO₂, pCO₂, mPAP, D-D, CTnI, and NT-proBNP in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 86.00% and 96.00%, respectively, and there was difference between two groups (P<0.05). After treatment, LVEDD and the LAEDD in two groups were significantly decreased, but LVEF in two groups were significantly increased (P<0.05). And the heart function indexes in the treatment group were significantly better than those in the control group (P<0.05). After treatment, FEV1, PEF and FVC in two groups were significantly increased (P<0.05). And the pulmonary function indexes in the treatment group were significantly higher than those in the control group (P<0.05). After treatment, levels of pCO₂ and mPAP in two groups were significantly decreased, but levels of pO₂ in two groups were significantly increased (P<0.05). And blood gas indexes and mPAP in the treatment group were significantly better than those in the control group (P<0.05). After treatment, levels of D-D, CTnI, and NT-proBNP in two groups were significantly decreased (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Phentolamine Mesylate Injection combined with Levocarnitine for injection has curative effect in treatment of chronic pulmonary heart disease, can improve lung function and heart function, with good safety, which was worthy of clinical application.

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