目的 探讨托拉塞米联合培哚普利治疗心力衰竭的临床疗效。方法 收集2016年1月-2017年4月在西安医学院第二附属医院进行治疗的心力衰竭患者82例，随机分为对照组（41例）和治疗组（41例）。对照组患者口服精氨酸培哚普利片，起始剂量为2 mg/次，1次/d，2周后以4 mg/次维持治疗，1次/d。治疗组在对照组的基础上静脉滴注托拉塞米注射液，初始剂量为10 mg加入250 mL生理盐水，1次/d，根据疗效可增至20 mg/d，最大剂量为40 mg/d。两组患者均治疗14 d。评价两组患者临床疗效，同时比较治疗前后两组患者心功能和血清学指标。结果 治疗后，对照组和治疗组总有效率分别为75.61%、92.68%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者左心室收缩末内径（LVEDD）、左心室收缩末容量（LVESV）和左心室舒张末内径（LVESD）均明显降低，左心室射血分数（LVEE）则明显升高，同组比较差异具有统计学意义（P<0.05）；且治疗组心功能指标改善程度显著优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者血清氨基末端脑利钠肽前体（NT-proBNP）、白介素-1β（IL-1β）、细胞间黏附分子-1（ICAM-1）和超敏C反应蛋白（hs-CRP）水平均明显降低，同组比较差异具有统计学意义（P<0.05）；且治疗组血清学指标比对照组降低更显著，两组比较差异具有统计学意义（P<0.05）。结论 托拉塞米联合培哚普利片治疗心力衰竭可明显改善患者心功能，降低机体炎症反应，具有一定的临床推广应用价值。

Objective To investigate the clinical curative effect of torasemide combined with perindopril in treatment of heart failure. Methods Patients (82 cases) with heart failure in the Second Affiliated Hospital of Xi'an Medical College from January 2016 to April 2017 were randomly divided into control (41 cases) and treatment (41 cases) groups. Patients in the control group were po administered with Perindopril Arginine Tablets, the initial dosage was 2 mg/time, once daily, then the maintain dosage was 2 mg/time after two weeks, once daily. Patients in the treatment group were iv administered with Torsemide Injection on the basis of the control group, the initial dosage was 10 mg added into 250 mL normal saline, once daily, which was increased to 20 mg/d according to the efficacy, and the maximum dose was 40 mg/d. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the cardiac function indexes and serological markers in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 75.61% and 92.68%, respectively, and there were differences between two groups (P<0.05). After treatment, the LVEDD, LVESV and LVESD in two groups were significantly decreased, LVEE was significantly increased, and the difference was statistically significant in the same group (P<0.05). And the cardiac function indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of hs-CRP, NT-proBNP, ICAM-1 and IL-1β in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). These serological markers in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Torasemide combined with perindopril can significantly improve heart function in treatment of heart failure, and reduce the inflammatory reactions, which has a certain clinical application value.