目的 探討阿托伐他汀鈣聯(lián)合米力農(nóng)注射液治療慢性心力衰竭的臨床療效。方法 選取2018年12月—2019年12月于河南省人民醫(yī)院進行治療的慢性心力衰竭患者93例，隨機分為對照組（46例）和治療組（47例）。對照組iv米力農(nóng)注射液，首次采用50 μg/kg負荷劑量靜脈推注10 min，隨后以0.25～0.50 μg/（kg·min）靜脈勻速泵入，連續(xù)使用72 h；治療組患者則在對照組基礎(chǔ)上口服阿托伐他汀鈣片，10 mg/次，2次/d。兩組均連續(xù)治療1周。觀察兩組的臨床療效，比較兩組治療前后臨床癥狀評分、6 min步行距離、心功能指標(biāo)及血清去甲腎上腺素、細胞間黏附分子-1（ICAM-1）、超敏C反應(yīng)蛋白（hs-CRP）、醛固酮（ALD）、腦自然肽氨基端前體蛋白（NT-proBNP）、心肌肌鈣蛋白 I（cTnI）水平。結(jié)果 治療后，對照組臨床總有效率78.26%明顯低于治療組93.62%，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患者臨床癥狀評分顯著降低，但6 min步行距離顯著升高（P<0.05）；且治療后治療組臨床癥狀評分和6 min步行距離相較于對照組改善更為顯著（P<0.05）。治療后，兩組患者心功能指標(biāo)左心室射血分?jǐn)?shù)（LVEE）、左心室收縮末內(nèi)徑（LVESD）、左心室收縮末期容積（LVESV）均較治療前明顯改善（P<0.05）；且治療后治療組心功能相關(guān)指標(biāo)相較于對照組改善更為顯著（P<0.05）。治療后，兩組患者血清去甲腎上腺素、ICAM-1、hs-CRP、ALD、NT-proBNP、cTnI水平均較治療前明顯降低（P<0.05）；且治療后治療組這些相關(guān)血清生化指標(biāo)顯著低于對照組（P<0.05）。結(jié)論 阿托伐他汀鈣聯(lián)合米力農(nóng)注射液治療慢性心力衰竭療效確切，能顯著改善患者臨床癥狀及心功能指標(biāo)，可改善患者相關(guān)血清生化指標(biāo)，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the effectiveness of atorvastatin calcium combined with Milrinone Injection in treatment of chronic heart failure. Methods A total of 93 patients with chronic heart failure who were treated in Henan Provincial People's Hospital from December 2018 to December 2019 were selected for clinical research. The patients were randomly divided into control group (46 cases) and treatment group (47 cases). The control group was iv Milrinone Injection, for the first time, 50 μg/kg loading dosage was injected intravenously for 10 min. Then, 0.25 — 0.50 μg/(kg·min) was injected intravenously at a constant speed for 72 h. The treatment group was po administered with Atorvastatin Calcium Tablets on the basis of the control group, 10 mg/time, twice daily. All patients were treated for 1 week. The clinical effects of two groups were observe, clinical symptom scores in two groups before and after the treatment, 6 min walking distance, cardiac function indexes and serum norepinephrine, intercellular adhesion molecule 1 (ICAM 1), hypersensitive c-reactive protein (hs-CRP), aldosterone (ALD), brain natural peptide precursor protein amino end (NT-proBNP), cardiac troponin I (cTnI) level were compared. Results After treatment, the total clinical effective rate in the control group (78.26%)was significantly lower than that in the treatment group (93.62 %), and there were differences between two groups (P<0.05). The clinical symptom score of the two groups was significantly reduced, but the walking distance of 6 min was significantly increased (P<0.05). After treatment, the clinical symptom score and 6 min walking distance in the treatment group were more significantly improved than those in the control group (P<0.05). After treatment, LVEE, LVESD, and LVESV were significantly improved in both groups compared with those before treatment (P<0.05). After treatment, the improvement of cardiac function indexes in the treatment group was more significant than those in the control group (P<0.05). After treatment, the serum levels of noradrenaline, ICAM-1, hs-CRP, ALD, NT-proBNP, and cTnI in both groups were significantly lower than those before treatment (P<0.05). After treatment, these serum biochemical indexes in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Atorvastatin calcium combined with Milrinone Injection has a definite therapeutic effect in treatment of chronic heart failure, and can significantly improve the clinical symptoms and cardiac function indexes, and can improve the relevant serum biochemical indicators, which has a certain clinical application value.

R972

河南省醫(yī)學(xué)科技計劃項目（201602226）