目的 探讨依普利酮联合比索洛尔治疗慢性心力衰竭的临床疗效及对心功能指标、炎性因子的影响。方法 回顾性研究选取2024年6月—2025年6月武汉市第一医院心血管内科收治的92例慢性心力衰竭患者为研究对象，按照随机数字法分为对照组和治疗组，每组46例。对照组患者给予口服富马酸比索洛尔片，2.5 mg/次，1次/d。治疗组在对照组的基础上给予依普利酮片，25 mg/次，1次/d。两组用药28 d。观察两组的临床疗效和临床症状好转时间，比较治疗前后6 min步行距离（6MWD）、左心室射血分数（LVEF）、明尼苏达心功能不全生命质量量表（MLHFQ）和血清炎性因子水平的变化情况。结果 用药后，治疗组总有效率是95.65%，显著高于对照组的82.61%（P＜0.05）。治疗后，与对照组对比，治疗组出现呼吸困难、全身乏力、下肢浮肿、食欲不振等症状好转时间均显著更短（P＜0.05）。治疗后，两组患者6MWD、LVEF较同组治疗前显著提高，而MLHFQ评分降低（P＜0.05）；且治疗后治疗组6MWD、LVEF高于对照组，MLHFQ评分低于对照组（P＜0.05）。治疗后，两组转化生长因子-β1（TGF-β1）、B型钠尿肽（BNP）、白细胞介素6（IL-6）、血清可溶性生长刺激表达因子2（sST2）水平均显著降低（P＜0.05）；治疗后，与对照组对比，治疗组患者TGF-β1、BNP、IL-6、sST2水平均更低（P＜0.05）。结论 依普利酮联合比索洛尔在慢性心力衰竭患者中显示出良好的治疗效果，可以缩短临床症状改善时间，改善心功能相关指标，降低血清因子水平。

Objective To explore the clinical efficacy of eprimolone combined with bisoprolol in treatment of chronic heart failure and its influence on cardiac function indicators and inflammatory factors Methods A retrospective study selected 92 patients with chronic heart failure admitted to the Department of Cardiology of Wuhan First Hospital from June 2024 to June 2025 as the research subjects. They were randomly divided into control group and treatment group according to the random number method, with 46 cases in each group. Patients in control group were given oral Bisoprolol Fumarate Tablets, 2.5 mg each time, once daily. Patients in treatment group were po administered with Eplerenone Tablets on the basis of control group, 25 mg each time, once daily. Both groups were treated with medication for 28 d. The clinical efficacy and the improvement time of clinical symptoms of two groups were observed, and the changes of 6MWD, LVEF, MLHFQ score, and serum inflammatory factor levels were compared before and after treatment. Results After medication, the total effective rate of treatment group was 95.65%, significantly higher than that of control group (82.61%, P < 0.05). After treatment, compared with control group, the improvement time of symptoms such as breathing difficulties, general weakness, lower extremity edema and loss of appetite in treatment group was significantly shorter (P < 0.05). After treatment, the 6MWD and LVEF of two groups of patients were significantly increased compared with those before treatment in the same group, but MLHFQ score decreased (P < 0.05). Moreover, after treatment, the 6MWD and LVEF of treatment group were higher than those of control group, and the MLHFQ score was lower than that of control group (P < 0.05). After treatment, the levels of TGF-β1, BNP, IL-6, and sST2 in both groups were significantly decreased (P < 0.05). After treatment, compared with control group, the levels of TGF-β1, BNP, IL-6, and sST2 in treatment group were all lower (P < 0.05). Conclusion Eprimolone combined with bisoprolol has shown a good therapeutic effect in patients with chronic heart failure, which can shorten the time for clinical symptom improvement, improve cardiac function-related indicators, and reduce serum factor levels.

R972

武汉市医学科研项目（WX21D35）