目的 探討鹽酸奧普力農(nóng)聯(lián)合硝普鈉治療急性心力衰竭的臨床療效。方法 選取2014年5月—2017年5月在中國(guó)人民解放軍第一七五醫(yī)院（廈門大學(xué)附屬東南醫(yī)院）進(jìn)行治療的150例急性心力衰竭患者,根據(jù)用藥的差別分為治療組（75例）和對(duì)照組（75例）。對(duì)照組給予注射用硝普鈉，50 mg與5%葡萄糖注射液500 mL配伍，開(kāi)始以0.5 μg/(kg·min)靜脈滴注，根據(jù)反應(yīng)以0.5 μg/(kg·min)遞增至3 μg/(kg·min)，連續(xù)應(yīng)用3 d。治療組在對(duì)照組治療基礎(chǔ)上給予鹽酸奧普力農(nóng)注射液，初始劑量為10 μg/kg，緩慢靜脈注射5 min，隨后以0.1～0.3 μg/kg·min的劑量靜脈滴注，必要時(shí)以0.4 μg/(kg·min)的劑量增加。兩組均治療3 d。觀察兩組的臨床療效，比較兩組治療前后心功能指標(biāo)、血清學(xué)指標(biāo)、QRS積分、心肌梗死面積的變化情況。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別是85.33%、97.33%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，治療后兩組左心室射血分?jǐn)?shù)（LVEE）顯著升高，左室舒張末期內(nèi)徑（LVEDD）、左心室收縮末內(nèi)徑（LVESD）、左心室收縮末期容積（LVESV）顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療后，治療組LVEE高于對(duì)照組，LVEDD、LVESD、LVESV低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組經(jīng)治療C反應(yīng)蛋白（hs-CRP）、氨基末端腦鈉肽前體（NT-proBNP）、肌鈣蛋白（cTnT）、胱抑素C（Cys-C）、內(nèi)皮素-1（ET-1）、QRS積分、心肌梗死面積均顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療后，治療組hs-CRP、NT-proBNP、cTnT、Cys-C、ET-1水平、QRS積分、心肌梗死面積顯著低于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 鹽酸奧普力農(nóng)聯(lián)合硝普鈉治療急性心力衰竭具有較好的臨床療效，可有效改善患者心功能，降低機(jī)體炎癥反應(yīng)，保護(hù)心肌細(xì)胞受損，有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy of olprinone combined with nitroprusside in treatment of senile acute heart failure. Methods 150 Patients with senile acute heart failure in the 175th Hospital of Chinese People's Liberation Army (Southeast Hospital Affiliated to Xiamen University) from May 2014 to May 2017 were divided into control group (75 cases) and treatment group (75 cases) according to the difference of drug use. Patients in the control group were given Sodium Nitroprusside for injection, 50 mg was combined with 5% Glucose Injection 500 mL, and intravenous infusion was started at 0.5 μg/(kg·min). According to the reaction, the infusion was increased by 0.5 μg/(kg·min) to 3 μg/(kg·min), and the application was continued for 3 days. Patients in the treatment group were given Olprinone Hydrochloride Injection on the basis of the control group, the initial dosage was 10 μg/kg, given slowly intravenously for 5 min, followed by intravenous drip at a dosage of 0.1 - 0.3 μg/kg·min, if necessary, at a dosage of 0.4 μg/kg·min. Patients in two groups were treated for 3 d. After treatment, the clinical efficacy was evaluated, and the changes of cardiac function indexes, serological indexes, QRS score, and myocardial infarction area in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment group were 85.33% and 97.33%, and there were differences between two groups (P<0.05). After treatment, LVEE in the two groups were significantly increased, but LVEDD, LVESD, and LVESV were significantly decreased, and there were differences in the same group (P<0.05). After treatment, LVEE in the treatment group was higher than those in the control group, but LVEDD, LVESD, and LVESV were lower than those in the control group, and there were differences between two groups (P<0.05). After treatment, hs-CRP, NT-proBNP, cTnT, Cys-C, ET-1, QRS score, and myocardial infarction area were significantly decreased, and there were differences in the same group (P<0.05). After treatment, hs-CRP, NT-proBNP, cTnT, Cys-C, ET-1, QRS score, and myocardial infarction area were lower than those in the control group, and there were differences between two groups (P<0.05). Conclusion Olprinone combined with nitroprusside has significant clinical effect in treatment of senile acute heart failure, and can effectively improve the heart function, also can reduce the body's inflammatory response, and protect the myocardial cells from damage, which has a certain clinical application value.