目的 探讨托伐普坦片联合马来酸桂哌齐特注射液治疗急性心力衰竭的临床疗效。方法 选取2015年4月—2017年4月天津市泰达医院收治的急性心力衰竭患者86例为研究对象，所有患者在随机分组原则下分为对照组和治疗组，每组各43例。对照组静脉滴注马来酸桂哌齐特注射液，40 mL加入到生理盐水500 mL中，1次/d。治疗组在对照组基础上口服托伐普坦片，1片/次，1次/d。两组患者均连续治疗15 d。观察两组的临床疗效，比较两组的心功能、肾功能和心衰指标。结果 治疗后，对照组和治疗组的总有效率分别为76.74%、95.35%，两组比较差异有统计学意义（P<0.05）。治疗后，两组左心室射血分数（LVEF）、左心室舒张末期内径（LVEDD）、肾小球滤过率（GFR）和尿量均显著升高，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组这些观察指标明显高于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组N端前脑钠肽（NT-proBNP）、肌酸激酶同工酶（CK-MB）和心肌肌钙蛋白（cTnI）水平均显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组这些观察指标明显低于对照组，两组比较差异具有统计学意义（P<0.05）。结论 托伐普坦片联合马来酸桂哌齐特注射液治疗急性心力衰竭具有较好的临床疗效，可改善心功能和肾功能，调节NT-proBNP、CK-MB和cTnI水平，安全性较好，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Tolvaptan Tablets combined with Cinepazide Maleate Injection in treatment of acute heart failure. Methods Patients (86 cases) with acute heart failure in Tianjin TEDA Hospital from April 2014 to April 2017 were randomly divided into control and treatment groups, and each group had 43 cases. Patients in the control group were iv administered with Cinepazide Maleate Injection, 40 mL added into normal saline 500 mL, once daily. Patients in the treatment group were po administered with Tolvaptan Tablets on the basis of the control group, 1 tablet/time, once daily. Patients in two groups were treated for 15 d. After treatment, the clinical efficacies were evaluated, and cardiac function, renal function, and heart failure indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 76.74% and 95.35%, respectively, and there was difference between two groups (P < 0.05). After treatment, LVEF, LVEDD, GFR, urine volume in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the levels of NT-proBNP, CK-MB, and cTnI in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Tolvaptan Tablets combined with Cinepazide Maleate Injection has clinical curative effect in treatment of acute heart failure, can improve cardiac function and renal function, regulate the levels of NT-proBNP, CK-MB, and cTnI, with good safety, which has a certain clinical application value.