目的 探讨养心定悸颗粒联合左西孟旦注射液治疗老年慢性心力衰竭的临床疗效。方法 选取2021年7月—2023年5月南京江北医院收治的120例老年慢性心力衰竭患者，采用随机数字表法将所有患者分为对照组和治疗组，每组60例。对照组起始静脉注射负荷量左西孟旦注射液12 μg/kg，随后静脉滴注0.15～0.20 μg/(kg·min)，1次/周。治疗组在对照组治疗的基础上口服养心定悸颗粒，1袋/次，2次/d。两组均连续治疗1个月。对比两组临床疗效、心功能指标、运动耐量、生活质量、心肌酶谱指标。结果 治疗组的总有效率91.67%高于对照组78.33%（P＜0.05）。治疗后，两组每搏输出量（SV）、左室射血分数（LVEF）、心输出量（CO）升高，左室收缩末期内径（LVESD）、左室舒张末期内径（LVEDD）下降（P＜0.05），治疗组SV、LVEF、CO高于对照组，LVESD、LVEDD低于对照组（P＜0.05）。治疗后，两组6 min内最远步行距离试验（6MWT）距离增加，明尼苏达心力衰竭生活质量量表（MLHFQ）评分下降（P＜0.05），且治疗组的6MWT距离高于对照组，MLHFQ评分低于对照组（P＜0.05）。治疗后，两组天冬氨酸转氨酶（AST）、磷酸肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）水平下降（P＜0.05），治疗组AST、CK-MB、LDH水平低于对照组（P＜0.05）。结论 养心定悸颗粒联合左西孟旦注射液能够显著提高老年慢性心力衰竭患者的临床疗效，增强运动耐量，提升生活质量，改善心功能和心肌酶谱指标。

Objective To investigate the clinical efficacy of Yangxin Dingji Granules combined with Levosimendan Injection in treatment of senile chronic heart failure. Methods120 Senile chronic heart failure patients who were admitted in Nanjing Jiangbei Hospital from July 2021 to May 2023 were divided into control group and treatment group using random number table method, 60 cases per group. The control group received an initial intravenous injection load of 12 μg/kg Levosimendan Injection, followed by intravenous infusion of 0.15 — 0.20 μg/(kg·min), once weekly. On the basis of the control group, the treatment group were po administered with Yangxin Dingji Granules, 1 bag/time, twice daily. Both groups received continuous treatment for one month. The clinical efficacy, heart function indexes, exercise tolerance, quality of life, and myocardial enzyme spectrum indexes were compared between two groups. Results The total clinical effectiveness 91.6778.33% in treatment group was higher than 78.33% in the control group (P < 0.05). After treatment, SV, LVEF, and CO were increased in both groups, while LVESD and LVEDD were decreased (P < 0.05). SV, LVEF, and CO in the treatment group were higher than those in the control group, while LVESD and LVEDD were lower than those in the control group (P < 0.05). After treatment, 6MWT distance was increased in both groups, but MLHFQ scores were decreased (P < 0.05). 6MWT distance in the treatment group was higher than that in the control group, but MLHFQ score was lower than that in the control group (P < 0.05). After treatment, the levels of AST, CK-MB, and LDH were decreased in both groups (P < 0.05), and the levels of AST, CK-MB, and LDH in the treatment group were lower than those in the control group (P < 0.05). Conclusion Yangxin Dingji Granules combined with Levosimendan Injection has good clinical effect in treatment of senile chronic heart failure, and can improve the clinical efficacy, effectively improve the exercise tolerance, and further improve the quality of life, heart function and myocardial enzyme spectrum indexes.

R972

江苏省卫生健康委医学科研立项项目（ZDX2021-249）