目的 探究培哚普利叔丁胺联合地高辛治疗老年充血性心衰患者的临床疗效。方法 选取2022年5月—2023年5月在沧州市中心医院治疗的老年充血性心力衰竭患者115例，根据治疗方案分成对照组（57例）和治疗组（58例）。对照组口服地高辛片，0.25 mg/次，1次/d；治疗组在对照组基础上口服培哚普利叔丁胺片，4 mg/次，1次/d。两组患者均治疗8周。观察两组患者临床疗效，比较治疗前后两组患者生活质量和运动耐力，心室重构指标左心室后壁厚度（LVPWT）、左心室舒张末期后壁厚度（LVPWd）、左心室收缩末期后壁厚度（LVPWs）和左心室舒张末期球形指数（LVSId）水平，及血清聚集素蛋白（Clusterin）、胱抑素C（Cys-C）、可溶性细胞间粘附分子1（sICAM-1）和同型半胱氨酸（Hcy）水平。结果 治疗后，治疗组和对照组临床总有效率分别为93.10%、75.44%（P＜0.05）。治疗后，两组患者MLHFQ评分均明显降低，6 min步行距离均明显提升（P＜0.05），且治疗组MLHFQ评分和6 min步行距离改善更为明显（P＜0.05）。治疗后，两组患者LVPWT、LVPWd、LVPWs、LVSId、Clusterin、Cys-C、sICAM-1和Hcy水平均明显降低（P＜0.05），且治疗组这些指标水平明显低于对照组（P＜0.05）。结论 培哚普利叔丁胺联合地高辛治疗老年充血性心力衰竭疗效显著，不仅能够显著改善患者运动耐力和生活质量，同时还能够促进血清学指标的恢复并有效抑制心室重构。

Objective To explore the clinical efficacy of perindopril tert-butylamine combined with digoxin in treatment of elderly congestive heart failure. Methods Patients (115 cases) with elderly congestive heart failure in Cangzhou Central Hospital from May 2022 to May 2023 were randomly divided into control (57 cases) and treatment (58 cases) group. Patients in the control group were po administered with Digoxin Tablets, 0.25 mg/time, once daily. Patients in the treatment group were po administered with Perindopril tert-Butylamine Tablets on the basis of the control group, 4 mg/time, once daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical evaluations were evaluated, the quality of life and exercise endurance, the levels of ventricular remodeling indicators LVPWT, LVPWd, LVPWs and LVSId, the levels of serum Clusterin, Cys-C, sICAM-1 and Hcy in two groups before and after treatment were compared. Results After treatment, the total clinical effective rate of the treatment group and the control group was 93.10% and 75.44% respectively (P < 0.05). After treatment, the MLHFQ score was significantly decreased, and the 6 min walking distance was significantly increased in two groups (P < 0.05), and the MLHFQ score and 6 min walking distance were significantly improved in the treatment group (P < 0.05). After treatment, the levels of LVPWT, LVPWd, LVPWs, LVSId, Clusterin, Cys-C, sICAM-1 and Hcy in the two groups were significantly decreased (P < 0.05), and the levels of these indexes in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion The combination of perindopril tert butylamine and digoxin tablets has a significant therapeutic effect on elderly patients with congestive heart failure. It can not only significantly improve exercise endurance and quality of life, but also promote the recovery of serological indicators and effectively inhibit ventricular remodeling, which has clinical promotion value.

R972

河北省重点研发计划项目（20211799）