目的 探讨阿托伐他汀钙联合米力农注射液治疗慢性心力衰竭的临床疗效。方法 选取2018年12月—2019年12月于河南省人民医院进行治疗的慢性心力衰竭患者93例，随机分为对照组（46例）和治疗组（47例）。对照组iv米力农注射液，首次采用50 μg/kg负荷剂量静脉推注10 min，随后以0.25～0.50 μg/（kg·min）静脉匀速泵入，连续使用72 h；治疗组患者则在对照组基础上口服阿托伐他汀钙片，10 mg/次，2次/d。两组均连续治疗1周。观察两组的临床疗效，比较两组治疗前后临床症状评分、6 min步行距离、心功能指标及血清去甲肾上腺素、细胞间黏附分子-1（ICAM-1）、超敏C反应蛋白（hs-CRP）、醛固酮（ALD）、脑自然肽氨基端前体蛋白（NT-proBNP）、心肌肌钙蛋白 I（cTnI）水平。结果 治疗后，对照组临床总有效率78.26%明显低于治疗组93.62%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者临床症状评分显著降低，但6 min步行距离显著升高（P<0.05）；且治疗后治疗组临床症状评分和6 min步行距离相较于对照组改善更为显著（P<0.05）。治疗后，两组患者心功能指标左心室射血分数（LVEE）、左心室收缩末内径（LVESD）、左心室收缩末期容积（LVESV）均较治疗前明显改善（P<0.05）；且治疗后治疗组心功能相关指标相较于对照组改善更为显著（P<0.05）。治疗后，两组患者血清去甲肾上腺素、ICAM-1、hs-CRP、ALD、NT-proBNP、cTnI水平均较治疗前明显降低（P<0.05）；且治疗后治疗组这些相关血清生化指标显著低于对照组（P<0.05）。结论 阿托伐他汀钙联合米力农注射液治疗慢性心力衰竭疗效确切，能显著改善患者临床症状及心功能指标，可改善患者相关血清生化指标，具有一定的临床推广应用价值。

Objective To investigate the effectiveness of atorvastatin calcium combined with Milrinone Injection in treatment of chronic heart failure. Methods A total of 93 patients with chronic heart failure who were treated in Henan Provincial People's Hospital from December 2018 to December 2019 were selected for clinical research. The patients were randomly divided into control group (46 cases) and treatment group (47 cases). The control group was iv Milrinone Injection, for the first time, 50 μg/kg loading dosage was injected intravenously for 10 min. Then, 0.25 — 0.50 μg/(kg·min) was injected intravenously at a constant speed for 72 h. The treatment group was po administered with Atorvastatin Calcium Tablets on the basis of the control group, 10 mg/time, twice daily. All patients were treated for 1 week. The clinical effects of two groups were observe, clinical symptom scores in two groups before and after the treatment, 6 min walking distance, cardiac function indexes and serum norepinephrine, intercellular adhesion molecule 1 (ICAM 1), hypersensitive c-reactive protein (hs-CRP), aldosterone (ALD), brain natural peptide precursor protein amino end (NT-proBNP), cardiac troponin I (cTnI) level were compared. Results After treatment, the total clinical effective rate in the control group (78.26%)was significantly lower than that in the treatment group (93.62 %), and there were differences between two groups (P<0.05). The clinical symptom score of the two groups was significantly reduced, but the walking distance of 6 min was significantly increased (P<0.05). After treatment, the clinical symptom score and 6 min walking distance in the treatment group were more significantly improved than those in the control group (P<0.05). After treatment, LVEE, LVESD, and LVESV were significantly improved in both groups compared with those before treatment (P<0.05). After treatment, the improvement of cardiac function indexes in the treatment group was more significant than those in the control group (P<0.05). After treatment, the serum levels of noradrenaline, ICAM-1, hs-CRP, ALD, NT-proBNP, and cTnI in both groups were significantly lower than those before treatment (P<0.05). After treatment, these serum biochemical indexes in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Atorvastatin calcium combined with Milrinone Injection has a definite therapeutic effect in treatment of chronic heart failure, and can significantly improve the clinical symptoms and cardiac function indexes, and can improve the relevant serum biochemical indicators, which has a certain clinical application value.

R972

河南省医学科技计划项目（201602226）