目的 探讨芪苈强心胶囊联合硝酸甘油治疗急性左心衰竭的临床效果。方法 选取2016年3月-2019年1月渭南市中心医院收治的急性左心衰竭患者102例，随机分成对照组（51例）和治疗组（51例）。对照组静脉输注硝酸甘油注射液，以5 μg/min恒速泵入。治疗组在对照组基础上口服芪苈强心胶囊，4粒/次，3次/d。两组患者连续治疗7 d。观察两组患者临床疗效，同时比较治疗前后两组患者左室射血分数（LVEF）、左心室舒张末期内径（LVEDD）、左心房压力（LAP）、IVC直径（IVCD）和肺动脉收缩压（PSAP），血清心肌肌钙蛋白I（cTnI）、cTnT、生长分化因子-15（GDF-15）、可溶性ST2（sST2）含量，血浆B型利钠肽（BNP）浓度，一氧化氮（NO）/内皮素（ET）比值及D-二聚体（D-D）、C反应蛋白（CRP）水平。结果 治疗后，对照组临床有效率为80.4%，显著低于治疗组的94.1%，两组比较差异有统计学意义（P<0.05）。治疗后，两组LVEF值均显著升高（P<0.05），而LVEDD、LAP、IVCD、PSAP值均显著降低（P<0.05），且治疗组患者这些超声心动图参数明显好于对照组（P<0.05）。治疗后，两组患者血清cTnI、cTnT、GDF-15、sST2含量及血浆BNP浓度均显著低于治疗前（P<0.05），且治疗组患者这些指标明显低于对照组（P<0.05）。治疗后，两组患者血浆NO/ET比值显著升高（P<0.05），血浆D-D和血清CRP水平显著降低（P<0.05），且治疗组患者NO/ET比值及D-D、CRP水平明显好于对照组（P<0.05）。结论 芪苈强心胶囊联合硝酸甘油治疗急性左心衰竭疗效显著，可减轻心脏组织损伤，纠正血管内皮功能紊乱，改善微循环障碍，稳定病情。

Objective To investigate the clinical effect of Qili Qiangxin Capsules combined with nitroglycerin in treatment of acute left ventricular failure. Methods Patients (102 cases) with acute left ventricular failure in Weinan Central Hospital from March 2016 to January 2019 were randomly divided into control (51 cases) and treatment (51 cases) groups. Patients in the control group were intravenous infusion administered with Nitroglycerin Injection, pumped at constant speed of 5 μg/min. Patients in the treatment group were po administered with Qili Qiangxin Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacy was evaluated, and the LVEF, LVEDD, LAP, IVCD, PSAP, cTnI, cTnT, GDF-15, sST2, BNP, NO/ET, D-D, and CRP in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 80.4%, which was significantly lower than 94.1% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the LVEF value in two groups was significantly increased (P<0.05), but LVEDD, LAP, IVCD, PSAP value was significantly decreased (P<0.05), and these echocardiography parameters in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the serum concentration of cTnI, cTnT, GDF-15, sST2, and plasma concentration of BNP in two groups were significantly decreased (P<0.05), and these indexes in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the NO/ET of plasma in two groups was significantly increased (P<0.05), but plasma D-D and serum CRP levels were significantly decreased (P<0.05), and which in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Qili Qiangxin Capsules combined with nitroglycerin in treatment of acute left ventricular failure has significant clinical effect, can alleviate the injury of heart tissue, correct the disorder of vascular endothelial function, improve microcirculation disorder and stabilize the condition of the patients.