目的 探討注射用益氣復(fù)脈（凍干）聯(lián)合環(huán)磷腺苷葡胺注射液治療慢性心力衰竭的臨床療效。方法 選取2020年4月—2022年1月河南大學(xué)第一附屬醫(yī)院收治的慢性心力衰竭患者216例，按照隨機(jī)數(shù)字表法將患者分為對(duì)照組（108例）和治療組（108例）。對(duì)照組靜脈滴注環(huán)磷腺苷葡胺注射液60～180 mg，加入200～500 mL 5%葡萄糖注射液稀釋，1次/d。治療組在對(duì)照組的基礎(chǔ)上靜脈滴注注射用益氣復(fù)脈（凍干），8瓶/次，用5%葡萄糖注射液或生理鹽水250～500 mL稀釋，1次/d。兩組患者均治療2周。比較兩組總有效率、心功能指標(biāo)、心肌重構(gòu)指標(biāo)、運(yùn)動(dòng)耐力和血清炎癥因子指標(biāo)。結(jié)果 治療后，治療組的總有效率94.44%高于對(duì)照組的總有效率82.41%（P＜0.05）。治療后，兩組的左心室射血分?jǐn)?shù)（LVEF）、心輸出量（CO）均顯著升高（P＜0.05），治療組的LVEF、CO均高于對(duì)照組（P＜0.05）。治療后，兩組左心房?jī)?nèi)徑（LAP）、左室舒張末內(nèi)徑（LVEDD）、左室質(zhì)量指數(shù)（LVMI）均顯著下降，左室重構(gòu)指數(shù)（LVRI）升高（P＜0.05）；治療組的LAP、LVEDD、LVMI低于對(duì)照組，LVRI高于對(duì)照組（P＜0.05）。治療后，兩組6 min步行試驗(yàn)（6 MWT）顯著升高（P＜0.05），治療組的6 MWT顯著高于對(duì)照組（P＜0.05）。治療后，兩組血清超敏C反應(yīng)蛋白（hs-CRP）、白細(xì)胞介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）、N端前腦鈉肽（NT-proBNP）水平下降，治療組血清hs-CRP、IL-6、TNF-α、NT-proBNP水平較對(duì)照組低（P＜0.05）。結(jié)論 注射用益氣復(fù)脈（凍干）與環(huán)磷腺苷葡胺注射液聯(lián)合治療慢性心力衰竭患者可有效改善心功能和心肌重構(gòu)，降低炎癥因子水平。

Objective To investigate the clinical efficacy of Yiqi Fumai (lyophilized) for injection combined with Meglumine Adenosine Cyclophosphate Injection in treatment of chronic heart failure. Methods Patients (216 cases) with chronic heart failure in the First Affiliated Hospital of Henan University from April 2020 to January 2022 were divided into control and treatment groups according to random number tablet method, and each group had 108 cases. Patients in the control group were iv administered with Meglumine Adenosine Cyclophosphate Injection, 60 — 80 mg added into 5% glucose injection 200 — 500 mL, once daily. Patients in the treatment group were iv administered with Yiqi Fumai (lyophilized) for injection on the basis of the control group, 8 bottles added into 5% glucose injection 250 — 500 mL, once daily. Patients in two groups were treated for 2 weeks. The clinical efficacies, cardiac function indicators, myocardial remodeling indicators, exercise endurance, and serum inflammatory factor indicators in two groups were compared. Results After treatment, the total effective rate of 94.44% in the treatment group was higher than that of 82.41% in the control group (P＜0.05). After treatment, LVEF and CO of two groups significantly increased (P＜0.05), and LVEF and CO of the treatment group were higher than those of the control group (P＜0.05). After treatment, LAP, LVEDD, and LVMI in two groups significantly decreased, while LVRI in two groups significantly increased (P＜ 0.05). LAP, LVEDD, and LVMI in the treatment group were lower than those in the control group, while LVRI in the treatment group was higher than those in the control group (P＜0.05). After treatment, 6 MWT of two groups significantly increased (P＜0.05), and 6 MWT of the treatment group was significantly higher than that of the control group (P＜ 0.05). After treatment, the serum levels of hs-CRP, IL-6, TNF-α, and NT-proBNP in two groups decreased, and the serum levels of hs-CRP, IL-6, TNF-α, and NT-proBNP in the treatment group were lower than those in the control group (P＜0.05). Conclusion Yiqi Fumai (lyophilized) for injection combined with Meglumine Adenosine Cyclophosphate Injection has a good effect in the treatment of patients with chronic heart failure, which can effectively improve heart function and myocardial remodeling, and reduce levels of inflammatory factors.

R972

開封市科技發(fā)展計(jì)劃項(xiàng)目（2203021）