目的 探讨门冬氨酸钾镁联合去乙酰毛花苷治疗重症心力衰竭的临床研究。方法 选取2019年1月—2021年12月平煤神马医疗集团总医院治疗的120例重症心力衰竭患者，按照随机数字表法将所有患者分为对照组和治疗组，每组各60例。对照组静脉注射去乙酰毛花苷注射液，0.6 mg/次，加入5%葡萄糖注射液200 mL稀释后缓慢注射，1次/d。治疗组在对照组的治疗基础上静脉滴注门冬氨酸钾镁注射液，10 mL/次，加入0.9%氯化钠注射液250 mL中缓慢滴注，1次/d。两组均连续治疗7 d。观察两组临床疗效和症状缓解情况；比较两组左心室舒张末期内径（LVEDD）、左室射血分数（LVEF）、左房内径（LAD）、C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、氨基末端脑钠肽前体（NT-proBNP）、白细胞介素-6（IL-6）水平及不良反应。结果 治疗后，治疗组总有效率是98.33%，显著高于对照组的83.33%（P＜0.05）。治疗后，治疗组患者出现胸闷、头晕、呼吸困难、水肿等缓解时间均显著短于对照组（P＜0.05）。治疗后，两组LVEDD、LAD均较治疗前显著降低，而LVEF指标显著升高（P＜0.05）；治疗后，治疗组心功能指标改善优于对照组（P＜0.05）。治疗后，两组IL-6、NT-proBNP、TNF-α、CRP水平均较治疗前显著降低（P＜0.05），且治疗后治疗组血清学指标水平低于对照组（P＜0.05）。对照组患者不良反应发生率是15.00%；治疗组不良反应发生率是6.67%，治疗组不良反应发生率明显低于对照组（P＜0.05）。结论 门冬氨酸钾镁联合去乙酰毛花苷治疗重症心力衰竭效果较好，能显著改善心功能，增加心排血量，并能降低炎性因子，值得临床使用。

Objective To investigate the clinical study potassium aspartate and magnesium aspartate combined with deslanoside in treatment of severe heart failure. Methods A total of 120 patients with severe heart failure treated in General Hospital of Pingmei Shenma Group from January 2019 to December 2021 were selected, and all patients were divided into control group and treatment group according to random number table method, with 60 cases in each group. Patients in the control group were iv administered with Deslanoside Injection, 0.6 mg/time, added into 5% Glucose Injection 200 mL, then diluted and slowly injected, once daily. Patients in the treatment group were iv administered with Potassium Aspartate and Magnesium Aspartate Injection on the basis of the control group, 10 mL/time, add into physiological saline 250 mL slowly, once daily. Both groups were treated for 7 d. The clinical efficacy and symptom relief of the two groups were observed. The levels of left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), left atrial diameter (LAD), C-reactive protein (CRP), tumor necrosis factor -α (TNF-α), amino-terminal brain natriuretic peptide precursor (NT-probNP), interleukin-6 (IL-6) and adverse reactions were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 98.33%, significantly higher than that of the control group 83.33% (P < 0.05). After treatment, the relief time of chest tightness, dizziness, dyspnea and edema in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, LVEDD and LAD in two groups were significantly decreased compared with before treatment, while LVEF index was significantly increased (P < 0.05). After treatment, the improvement of cardiac function index in the treatment group was better than that in the control group (P < 0.05). After treatment, the levels of IL-6, NT-probNP, TNF-α and CRP in both groups were significantly lower than those before treatment (P < 0.05), and the serum indexes in the treatment group were lower than those in the control group (P < 0.05). The incidence of adverse reactions in control group was 15.00%. The incidence of adverse reactions in the treatment group was 6.67%, which was significantly lower than that in the control group (P < 0.05). Conclusion Potassium aspartate and magnesium aspartate combined with deslanoside has good effect in treatment of severe heart failure, and can significantly improve cardiac function, increase cardiac output, and can reduce inflammatory factors, which is worthy of clinical use.

R972

中华国际医学交流基金资助项目(Z-2017-24-2028-32)