目的 研究甲磺酸酚妥拉明注射液联合注射用左卡尼汀治疗慢性肺源性心脏病的临床疗效。方法 选取2018年6月-2019年6月天津市北辰区中医医院收治的100例慢性肺源性心脏病患者为研究对象，将所有患者随机分为对照组和治疗组，每组各50例。对照组患者静脉滴注注射用左卡尼汀，3 g/次，溶于250 mL 0.9%氯化钠注射液中，1次/d；治疗组患者在对照组基础上静脉滴注甲磺酸酚妥拉明注射液，10 mg/次，溶于250 mL 0.9%氯化钠注射液中，1次/d。两组患者持续治疗10 d。观察两组的临床疗效，比较两组心功能指标、肺功能指标、血气指标及平均肺动脉压（mPAP）、D-二聚体（D-D）、心肌肌钙蛋白I（CTnI）和N-末端脑钠肽前体（NT-proBNP）水平。结果 治疗后，对照组和治疗组总有效率分别为86.00%、96.00%，治疗组总有效率显著较高（P<0.05）。治疗后，两组患者左室舒张末期内径（LVEDD）和左房舒张末期内径（LAEDD）水平明显下降，左室射血分数（LVEF）水平明显升高（P<0.05）；并且治疗组心功能指标改善较多（P<0.05）。治疗后，两组患者第一秒用力呼气容积（FEV1）、最大呼气流量（PEF）和用力肺活量（FVC）水平显著升高（P<0.05）；并且治疗组肺功能指标升高较多（P<0.05）。治疗后，两组患者二氧化碳分压（pCO₂）和mPAP水平显著降低，氧分压（pO₂）水平显著升高（P<0.05）；并且治疗组血气指标和mPAP改善程度较大（P<0.05）。治疗后，两组患者D-D、CTnI和NT-proBNP水平显著降低（P<0.05）；并且治疗组降低较多（P<0.05）。结论 甲磺酸酚妥拉明注射液联合注射用左卡尼汀治疗慢性肺源性心脏病具有较好的疗效，可以改善肺功能和心功能，安全性较高，值得在临床上推广应用。

Objective To study the efficacy of Phentolamine Mesylate Injection combined with Levocarnitine for injection in treatment of chronic pulmonary heart disease. Methods Patients (100 cases) with chronic pulmonary heart disease in Tianjin Beichen District Hospital of Traditional Chinese Medicine from June 2018 to June 2019 were randomly divided into control and treatment groups, and each group had 50 cases. Patients in the control group were iv administered with Levocarnitine for injection, 3 g added into 0.9% sodium chloride injection solution 250 mL, once daily. Patients in the treatment group were iv administered with Phentolamine Mesylate Injection on the basis of the control group, 10 mg added into 0.9% sodium chloride injection solution 250 mL, once daily. Patients in two groups were treated for 10 d. After treatment, the clinical efficacies were evaluated, and heart function indexes, pulmonary function indexes, the levels of pO₂, pCO₂, mPAP, D-D, CTnI, and NT-proBNP in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 86.00% and 96.00%, respectively, and there was difference between two groups (P<0.05). After treatment, LVEDD and the LAEDD in two groups were significantly decreased, but LVEF in two groups were significantly increased (P<0.05). And the heart function indexes in the treatment group were significantly better than those in the control group (P<0.05). After treatment, FEV1, PEF and FVC in two groups were significantly increased (P<0.05). And the pulmonary function indexes in the treatment group were significantly higher than those in the control group (P<0.05). After treatment, levels of pCO₂ and mPAP in two groups were significantly decreased, but levels of pO₂ in two groups were significantly increased (P<0.05). And blood gas indexes and mPAP in the treatment group were significantly better than those in the control group (P<0.05). After treatment, levels of D-D, CTnI, and NT-proBNP in two groups were significantly decreased (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Phentolamine Mesylate Injection combined with Levocarnitine for injection has curative effect in treatment of chronic pulmonary heart disease, can improve lung function and heart function, with good safety, which was worthy of clinical application.

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