目的 探讨贝那普利联合米力农注射液治疗顽固性心力衰竭的安全性和有效性。方法 选取2019年8月—2020年8月在中国人民解放军联勤保障部队第九八九医院就诊的153例顽固性心力衰竭患者作为研究对象，按照入院顺序随机分成对照组（76例）和治疗组（77例）。对照组静脉泵入米力农注射液，先以50 μg/kg负荷剂量静脉推注，然后以0.5 μg/（kg·min）静脉泵入，每天18 h以上，每周连续治疗3 d；治疗组在对照组基础上口服盐酸贝那普利片，10 mg/次，1次/d。两组患者均连续治疗4周。观察两组患者临床疗效，比较治疗前后两组患者MLHFQ评分和Lee氏心衰评分，及血清去甲肾上腺素（NA）、心脏型脂肪酸结合蛋白（H-FABP）和氨基末端脑钠肽前体（NT-proBNP）水平。结果 治疗组总有效率为89.61%，明显高于对照组的77.63%（P<0.05）。治疗后，两组患者MLHFQ评分和Lee氏心衰评分均较治疗前显著下降（P<0.05），且治疗组相较于对照组下降的更显著（P<0.05）。治疗后，两组患者血清NA、H-FABP和NT-proBNP水平均较治疗前显著下降（P<0.05），治疗组比对照组下降的更显著（P<0.05）。结论 贝那普利联合米力农注射液能够显著提升顽固性心力衰竭的治疗效果，改善患者的心衰程度和生活质量，具有一定的临床推广应用价值。

Objective To investigate the safety and clinical efficacy of benazepril combined with milrinone in treatment of intractable heart failure. Methods Patients (153 cases) with intractable heart failure in NO.989 Hospital of PLA Joint Logistics Support Force from August 2019 to August 2020 were randomly divided into control (76 cases) and treatment (77 cases) groups according to the order of admission. Patients in the control group were iv administered with Milrinone Injection, started with 50 μg/kg loading dose intravenous injection, then injected intravenously with 0.5 μg/(kg·min) for more than 18 h, the treatment lasted for 3 d every week. Patients in the treatment group were po administered with Benazepril Hydrochloride Tablets on the basis of the control group, 10 mg/time, once daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the MLHFQ scores and Lee’s heart failure scores, and the serum levels of NA, H-FABP and NT-proBNP in two groups before and after treatment were compared.Results The total clinical effective rate of the treatment group was 89.61%, which was significantly higher than 77.63% of the control group (P < 0.05). After treatment, the MLHFQ score and Lee's heart failure score in two groups were significantly lower than those before treatment (P < 0.05), and the decrease in the treatment group was more significant than that in the control group (P < 0.05). After treatment, the levels of serum NA, H-FABP, and NT-proBNP in the two groups were significantly lower than those before treatment (P < 0.05), and the decrease in the treatment group was more significant than that in the control group (P < 0.05). Conclusion Benazepril combined with Milrinone Injection can significantly improve the therapeutic effect of intractable heart failure and improve the degree of heart failure and quality of life of patients, which has a certain clinical application value.

R972

河南省医学科技攻关计划项目（201501017）