目的 探討心通口服液聯(lián)合重組人腦利鈉肽治療急性心肌梗死后心力衰竭的臨床研究。方法 選取2016年3月—2019年12月鄭州大學(xué)第一附屬醫(yī)院接收的急性心肌梗死后心力衰竭患者126例，將患者隨機(jī)分為對照組和治療組，每組各63例。對照組給予凍干重組人腦利鈉肽，前90 s靜脈推注1.5 μg/kg沖擊治療，隨后以0.007 5 μg/（kg·min）速率靜脈滴注，連續(xù)滴注3 d。治療組在對照組的基礎(chǔ)上聯(lián)合口服心通口服液，20 mL/次，3次/d。兩組均治療4周。觀察兩組的臨床療效，比較兩組治療前后心功能和血清學(xué)指標(biāo)的變化情況。結(jié)果 治療后，治療組臨床總有效率是90.48%，顯著高于對照組的76.19%（P<0.05）。兩組治療后左心室收縮末期內(nèi)徑（LVESD）、左心室舒張末期內(nèi)徑（LVEDD）顯著降低，但左心室射血分?jǐn)?shù)（LVEF）升高（P<0.05）；治療后，治療組患者心功能指標(biāo)優(yōu)于對照組（P<0.05）。兩組治療后丙二醛（MDA）、白細(xì)胞介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）顯著降低，而超氧化物歧化酶（SOD）升高（P<0.05）；治療后，治療組血清學(xué)指標(biāo)優(yōu)于對照組（P<0.05）。結(jié)論 心通口服液聯(lián)合重組人腦利鈉肽治療急性心肌梗死后心力衰竭療效肯定，可有效改善患者心功能和血清學(xué)指標(biāo)，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the therapeutic effect of Xintong Oral Liquid combined with recombinant human brain natriuretic peptide in treatment of heart failure after acute myocardial infarction. Methods A total of 126 patients with heart failure after acute myocardial infarction admitted to the First Affiliated Hospital of Zhengzhou University from March 2016 to December 2019 were selected and randomly divided into control group and treatment group, with 63 patients in each group. The control group was given Lyophilized Recombinant Human Brain Natriuretic Peptide and intravenously injected with 1.5 μg/kg for 90 s, followed by intravenous infusion at the rate of 0.007 5 μg/(kg∙min) for 3 consecutive days. Patients in the treatment group were po administered with Xintong Oral Liquid on the basis of the control group, 20 mL/time, three times daily. Both groups were treated for 4 weeks. The clinical efficacy of the two groups was observed and the changes of cardiac function and serological indexes before and after treatment were compared between the two groups. Results After treatment, the total clinical effective rate of the treatment group was 90.48%, significantly higher than that of the control group (76.19%, P<0.05). After treatment, LVESD and LVEDD were significantly reduced in both groups, but LVEF was increased (P<0.05). After treatment, the cardiac function indexes of the treatment group were better than those of the control group (P<0.05). After treatment, MDA, IL-6, and TNF-α was significantly decreased, while SOD was increased in both groups (P<0.05). After treatment, the serological indexes of the treatment group were better than those of the control group (P<0.05). Conclusion Xintong Oral Liquid combined with recombinant human brain natriuretic peptide has a definite effect in treatment of heart failure after acute myocardial infarction, and can effectively improve cardiac function and serological indicators of patients, which has certain clinical application value.

R972

河南省醫(yī)學(xué)科技攻關(guān)項目（172102310111）