目的 探討門(mén)冬氨酸鉀鎂聯(lián)合去乙酰毛花苷治療重癥心力衰竭的臨床研究。方法 選取2019年1月—2021年12月平煤神馬醫(yī)療集團(tuán)總醫(yī)院治療的120例重癥心力衰竭患者，按照隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組，每組各60例。對(duì)照組靜脈注射去乙酰毛花苷注射液，0.6 mg/次，加入5%葡萄糖注射液200 mL稀釋后緩慢注射，1次/d。治療組在對(duì)照組的治療基礎(chǔ)上靜脈滴注門(mén)冬氨酸鉀鎂注射液，10 mL/次，加入0.9%氯化鈉注射液250 mL中緩慢滴注，1次/d。兩組均連續(xù)治療7 d。觀察兩組臨床療效和癥狀緩解情況；比較兩組左心室舒張末期內(nèi)徑（LVEDD）、左室射血分?jǐn)?shù)（LVEF）、左房?jī)?nèi)徑（LAD）、C反應(yīng)蛋白（CRP）、腫瘤壞死因子-α（TNF-α）、氨基末端腦鈉肽前體（NT-proBNP）、白細(xì)胞介素-6（IL-6）水平及不良反應(yīng)。結(jié)果 治療后，治療組總有效率是98.33%，顯著高于對(duì)照組的83.33%（P＜0.05）。治療后，治療組患者出現(xiàn)胸悶、頭暈、呼吸困難、水腫等緩解時(shí)間均顯著短于對(duì)照組（P＜0.05）。治療后，兩組LVEDD、LAD均較治療前顯著降低，而LVEF指標(biāo)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(duì)照組（P＜0.05）。治療后，兩組IL-6、NT-proBNP、TNF-α、CRP水平均較治療前顯著降低（P＜0.05），且治療后治療組血清學(xué)指標(biāo)水平低于對(duì)照組（P＜0.05）。對(duì)照組患者不良反應(yīng)發(fā)生率是15.00%；治療組不良反應(yīng)發(fā)生率是6.67%，治療組不良反應(yīng)發(fā)生率明顯低于對(duì)照組（P＜0.05）。結(jié)論 門(mén)冬氨酸鉀鎂聯(lián)合去乙酰毛花苷治療重癥心力衰竭效果較好，能顯著改善心功能，增加心排血量，并能降低炎性因子，值得臨床使用。

Objective To investigate the clinical study potassium aspartate and magnesium aspartate combined with deslanoside in treatment of severe heart failure. Methods A total of 120 patients with severe heart failure treated in General Hospital of Pingmei Shenma Group from January 2019 to December 2021 were selected, and all patients were divided into control group and treatment group according to random number table method, with 60 cases in each group. Patients in the control group were iv administered with Deslanoside Injection, 0.6 mg/time, added into 5% Glucose Injection 200 mL, then diluted and slowly injected, once daily. Patients in the treatment group were iv administered with Potassium Aspartate and Magnesium Aspartate Injection on the basis of the control group, 10 mL/time, add into physiological saline 250 mL slowly, once daily. Both groups were treated for 7 d. The clinical efficacy and symptom relief of the two groups were observed. The levels of left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), left atrial diameter (LAD), C-reactive protein (CRP), tumor necrosis factor -α (TNF-α), amino-terminal brain natriuretic peptide precursor (NT-probNP), interleukin-6 (IL-6) and adverse reactions were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 98.33%, significantly higher than that of the control group 83.33% (P < 0.05). After treatment, the relief time of chest tightness, dizziness, dyspnea and edema in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, LVEDD and LAD in two groups were significantly decreased compared with before treatment, while LVEF index 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 IL-6, NT-probNP, TNF-α and CRP in both groups were significantly lower than those before treatment (P < 0.05), and the serum indexes in the treatment group were lower than those in the control group (P < 0.05). The incidence of adverse reactions in control group was 15.00%. The incidence of adverse reactions in the treatment group was 6.67%, which was significantly lower than that in the control group (P < 0.05). Conclusion Potassium aspartate and magnesium aspartate combined with deslanoside has good effect in treatment of severe heart failure, and can significantly improve cardiac function, increase cardiac output, and can reduce inflammatory factors, which is worthy of clinical use.

R972

中華國(guó)際醫(yī)學(xué)交流基金資助項(xiàng)目(Z-2017-24-2028-32)