目的 探討?zhàn)B心定悸顆粒聯(lián)合左西孟旦注射液治療老年慢性心力衰竭的臨床療效。方法 選取2021年7月—2023年5月南京江北醫(yī)院收治的120例老年慢性心力衰竭患者，采用隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組，每組60例。對(duì)照組起始靜脈注射負(fù)荷量左西孟旦注射液12 μg/kg，隨后靜脈滴注0.15～0.20 μg/(kg·min)，1次/周。治療組在對(duì)照組治療的基礎(chǔ)上口服養(yǎng)心定悸顆粒，1袋/次，2次/d。兩組均連續(xù)治療1個(gè)月。對(duì)比兩組臨床療效、心功能指標(biāo)、運(yùn)動(dòng)耐量、生活質(zhì)量、心肌酶譜指標(biāo)。結(jié)果 治療組的總有效率91.67%高于對(duì)照組78.33%（P＜0.05）。治療后，兩組每搏輸出量（SV）、左室射血分?jǐn)?shù)（LVEF）、心輸出量（CO）升高，左室收縮末期內(nèi)徑（LVESD）、左室舒張末期內(nèi)徑（LVEDD）下降（P＜0.05），治療組SV、LVEF、CO高于對(duì)照組，LVESD、LVEDD低于對(duì)照組（P＜0.05）。治療后，兩組6 min內(nèi)最遠(yuǎn)步行距離試驗(yàn)（6MWT）距離增加，明尼蘇達(dá)心力衰竭生活質(zhì)量量表（MLHFQ）評(píng)分下降（P＜0.05），且治療組的6MWT距離高于對(duì)照組，MLHFQ評(píng)分低于對(duì)照組（P＜0.05）。治療后，兩組天冬氨酸轉(zhuǎn)氨酶（AST）、磷酸肌酸激酶同工酶（CK-MB）、乳酸脫氫酶（LDH）水平下降（P＜0.05），治療組AST、CK-MB、LDH水平低于對(duì)照組（P＜0.05）。結(jié)論 養(yǎng)心定悸顆粒聯(lián)合左西孟旦注射液能夠顯著提高老年慢性心力衰竭患者的臨床療效，增強(qiáng)運(yùn)動(dòng)耐量，提升生活質(zhì)量，改善心功能和心肌酶譜指標(biāo)。

Objective To investigate the clinical efficacy of Yangxin Dingji Granules combined with Levosimendan Injection in treatment of senile chronic heart failure. Methods120 Senile chronic heart failure patients who were admitted in Nanjing Jiangbei Hospital from July 2021 to May 2023 were divided into control group and treatment group using random number table method, 60 cases per group. The control group received an initial intravenous injection load of 12 μg/kg Levosimendan Injection, followed by intravenous infusion of 0.15 — 0.20 μg/(kg·min), once weekly. On the basis of the control group, the treatment group were po administered with Yangxin Dingji Granules, 1 bag/time, twice daily. Both groups received continuous treatment for one month. The clinical efficacy, heart function indexes, exercise tolerance, quality of life, and myocardial enzyme spectrum indexes were compared between two groups. Results The total clinical effectiveness 91.6778.33% in treatment group was higher than 78.33% in the control group (P < 0.05). After treatment, SV, LVEF, and CO were increased in both groups, while LVESD and LVEDD were decreased (P < 0.05). SV, LVEF, and CO in the treatment group were higher than those in the control group, while LVESD and LVEDD were lower than those in the control group (P < 0.05). After treatment, 6MWT distance was increased in both groups, but MLHFQ scores were decreased (P < 0.05). 6MWT distance in the treatment group was higher than that in the control group, but MLHFQ score was lower than that in the control group (P < 0.05). After treatment, the levels of AST, CK-MB, and LDH were decreased in both groups (P < 0.05), and the levels of AST, CK-MB, and LDH in the treatment group were lower than those in the control group (P < 0.05). Conclusion Yangxin Dingji Granules combined with Levosimendan Injection has good clinical effect in treatment of senile chronic heart failure, and can improve the clinical efficacy, effectively improve the exercise tolerance, and further improve the quality of life, heart function and myocardial enzyme spectrum indexes.

R972

江蘇省衛(wèi)生健康委醫(yī)學(xué)科研立項(xiàng)項(xiàng)目（ZDX2021-249）