目的 探讨心通口服液联合重组人脑利钠肽治疗急性心肌梗死后心力衰竭的临床研究。方法 选取2016年3月—2019年12月郑州大学第一附属医院接收的急性心肌梗死后心力衰竭患者126例，将患者随机分为对照组和治疗组，每组各63例。对照组给予冻干重组人脑利钠肽，前90 s静脉推注1.5 μg/kg冲击治疗，随后以0.007 5 μg/（kg·min）速率静脉滴注，连续滴注3 d。治疗组在对照组的基础上联合口服心通口服液，20 mL/次，3次/d。两组均治疗4周。观察两组的临床疗效，比较两组治疗前后心功能和血清学指标的变化情况。结果 治疗后，治疗组临床总有效率是90.48%，显著高于对照组的76.19%（P<0.05）。两组治疗后左心室收缩末期内径（LVESD）、左心室舒张末期内径（LVEDD）显著降低，但左心室射血分数（LVEF）升高（P<0.05）；治疗后，治疗组患者心功能指标优于对照组（P<0.05）。两组治疗后丙二醛（MDA）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）显著降低，而超氧化物歧化酶（SOD）升高（P<0.05）；治疗后，治疗组血清学指标优于对照组（P<0.05）。结论 心通口服液联合重组人脑利钠肽治疗急性心肌梗死后心力衰竭疗效肯定，可有效改善患者心功能和血清学指标，具有一定的临床推广应用价值。

Objective To investigate the therapeutic effect of Xintong Oral Liquid combined with recombinant human brain natriuretic peptide in treatment of heart failure after acute myocardial infarction. Methods A total of 126 patients with heart failure after acute myocardial infarction admitted to the First Affiliated Hospital of Zhengzhou University from March 2016 to December 2019 were selected and randomly divided into control group and treatment group, with 63 patients in each group. The control group was given Lyophilized Recombinant Human Brain Natriuretic Peptide and intravenously injected with 1.5 μg/kg for 90 s, followed by intravenous infusion at the rate of 0.007 5 μg/(kg∙min) for 3 consecutive days. Patients in the treatment group were po administered with Xintong Oral Liquid on the basis of the control group, 20 mL/time, three times daily. Both groups were treated for 4 weeks. The clinical efficacy of the two groups was observed and the changes of cardiac function and serological indexes before and after treatment were compared between the two groups. Results After treatment, the total clinical effective rate of the treatment group was 90.48%, significantly higher than that of the control group (76.19%, P<0.05). After treatment, LVESD and LVEDD were significantly reduced in both groups, but LVEF was increased (P<0.05). After treatment, the cardiac function indexes of the treatment group were better than those of the control group (P<0.05). After treatment, MDA, IL-6, and TNF-α was significantly decreased, while SOD was increased in both groups (P<0.05). After treatment, the serological indexes of the treatment group were better than those of the control group (P<0.05). Conclusion Xintong Oral Liquid combined with recombinant human brain natriuretic peptide has a definite effect in treatment of heart failure after acute myocardial infarction, and can effectively improve cardiac function and serological indicators of patients, which has certain clinical application value.

R972

河南省医学科技攻关项目（172102310111）