目的 探討貝那普利聯(lián)合米力農注射液治療頑固性心力衰竭的安全性和有效性。方法 選取2019年8月—2020年8月在中國人民解放軍聯(lián)勤保障部隊第九八九醫(yī)院就診的153例頑固性心力衰竭患者作為研究對象，按照入院順序隨機分成對照組（76例）和治療組（77例）。對照組靜脈泵入米力農注射液，先以50 μg/kg負荷劑量靜脈推注，然后以0.5 μg/（kg·min）靜脈泵入，每天18 h以上，每周連續(xù)治療3 d；治療組在對照組基礎上口服鹽酸貝那普利片，10 mg/次，1次/d。兩組患者均連續(xù)治療4周。觀察兩組患者臨床療效，比較治療前后兩組患者MLHFQ評分和Lee氏心衰評分，及血清去甲腎上腺素（NA）、心臟型脂肪酸結合蛋白（H-FABP）和氨基末端腦鈉肽前體（NT-proBNP）水平。結果 治療組總有效率為89.61%，明顯高于對照組的77.63%（P<0.05）。治療后，兩組患者MLHFQ評分和Lee氏心衰評分均較治療前顯著下降（P<0.05），且治療組相較于對照組下降的更顯著（P<0.05）。治療后，兩組患者血清NA、H-FABP和NT-proBNP水平均較治療前顯著下降（P<0.05），治療組比對照組下降的更顯著（P<0.05）。結論 貝那普利聯(lián)合米力農注射液能夠顯著提升頑固性心力衰竭的治療效果，改善患者的心衰程度和生活質量，具有一定的臨床推廣應用價值。

Objective To investigate the safety and clinical efficacy of benazepril combined with milrinone in treatment of intractable heart failure. Methods Patients (153 cases) with intractable heart failure in NO.989 Hospital of PLA Joint Logistics Support Force from August 2019 to August 2020 were randomly divided into control (76 cases) and treatment (77 cases) groups according to the order of admission. Patients in the control group were iv administered with Milrinone Injection, started with 50 μg/kg loading dose intravenous injection, then injected intravenously with 0.5 μg/(kg·min) for more than 18 h, the treatment lasted for 3 d every week. Patients in the treatment group were po administered with Benazepril Hydrochloride Tablets on the basis of the control group, 10 mg/time, once daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the MLHFQ scores and Lee’s heart failure scores, and the serum levels of NA, H-FABP and NT-proBNP in two groups before and after treatment were compared.Results The total clinical effective rate of the treatment group was 89.61%, which was significantly higher than 77.63% of the control group (P < 0.05). After treatment, the MLHFQ score and Lee's heart failure score in two groups were significantly lower than those before treatment (P < 0.05), and the decrease in the treatment group was more significant than that in the control group (P < 0.05). After treatment, the levels of serum NA, H-FABP, and NT-proBNP in the two groups were significantly lower than those before treatment (P < 0.05), and the decrease in the treatment group was more significant than that in the control group (P < 0.05). Conclusion Benazepril combined with Milrinone Injection can significantly improve the therapeutic effect of intractable heart failure and improve the degree of heart failure and quality of life of patients, which has a certain clinical application value.

R972

河南省醫(yī)學科技攻關計劃項目（201501017）