目的 探討單硝酸異山梨酯聯(lián)合培哚普利叔丁胺治療慢性心力衰竭的臨床療效。方法 選取2019年6月—2021年6月在駐馬店市中心醫(yī)院就診治療的108例慢性心力衰竭患者，按照隨機(jī)數(shù)字表法將患者分為對照組和治療組，每組54例。對照組患者早晨飯前口服培哚普利叔丁胺片，4 mg/次，1次/d。治療組患者在對照組的治療基礎(chǔ)上口服單硝酸異山梨酯片，1片/次，2次/d。兩組患者連續(xù)服用藥物7 d。觀察兩組的臨床療效，比較兩組臨床癥狀緩解時間、心功能指標(biāo)和血清炎性因子水平。結(jié)果 治療后，治療組患者總有效率是98.15%，顯著高于對照組的81.48%（P＜0.05）。治療組患者胸悶、乏力、胸痛、氣短等癥狀緩解時間均顯著短于對照組（P＜0.05）。治療后，兩組患者左室舒張末期內(nèi)徑（LVEDD）、左心室收縮末期內(nèi)徑（LVESD）均較治療前顯著降低，但左室射血分?jǐn)?shù)（LVEF）顯著升高（P＜0.05）；治療后，治療組心功能指標(biāo)改善優(yōu)于對照組（P＜0.05）。治療后，兩組患者血清白細(xì)胞介素6（IL-6）、氨基末端腦鈉肽前體（NT-proBNP）、腫瘤壞死因子α（TNF-α）、C反應(yīng)蛋白（CRP）水平均較治療前顯著降低（P＜0.05）；治療后，治療組患者血清炎性因子水平顯著低于對照組（P＜0.05）。結(jié)論 單硝酸異山梨酯聯(lián)合培哚普利叔丁胺治療慢性心力衰竭患者效果較好，能有效改善心功能狀態(tài)，降低心肌組織的炎癥反應(yīng)，值得臨床推廣應(yīng)用。

Objective To investigate the efficacy of isosorbide mononitrate combined with perindopril tert-butylamine in treatment of chronic heart failure.Methods A total of 108 patients with chronic heart failure treated in Zhumadian Central Hospital from June 2019 to June 2021 were selected and divided into control group and treatment group according to random number method, with 54 patients in each group. Patients in the control group were po administered with Perindopril tert-Butylamine Tablets before meals in the morning, 4 mg/time, once daily. Patients in the treatment group were po administered with Isosorbide Mononitrate Tablets on the basis of the control group, 1 tablet/time, twice daily. Patients in both groups continued to take drugs for 7 d. The clinical efficacy of the two groups were observed, and the clinical symptom relief time, cardiac function indexes and serum inflammatory factor levels were compared between the two groups.Results After treatment, the total effective rate in treatment group was 98.15%, significantly higher than that in control group (81.48%) (P < 0.05). The relief time of chest tightness, fatigue, chest pain, shortness of breath and other symptoms in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, left ventricular end diastolic diameter (LVEDD) and left ventricular end systolic diameter (LVESD) in two groups were significantly decreased compared with before treatment, but left ventricular ejection fraction (LVEF) was significantly increased (P < 0.05). After treatment, the improvement of cardiac function index in the treatment group was better than that in the control group (P < 0.05). After treatment, the levels of serum IL-6, NT-proBNP, TNF-α, and CRP in two groups were significantly decreased (P < 0.05). After treatment, the level of serum inflammatory factors in treatment group was significantly lower than that in control group (P < 0.05).Conclusion Isosorbide mononitrate combined with Perindopril tert-Butylamine Tablets has good curative effect in treatment of chronic heart failure, and can effectively improve the state of cardiac function and reduce the inflammatory response of myocardial tissue, which is worthy of clinical application.

R972

河北省醫(yī)學(xué)科學(xué)研究項目[冀工辦科教(2017)3號]