目的 探讨盐酸奥普力农联合硝普钠治疗急性心力衰竭的临床疗效。方法 选取2014年5月—2017年5月在中国人民解放军第一七五医院（厦门大学附属东南医院）进行治疗的150例急性心力衰竭患者,根据用药的差别分为治疗组（75例）和对照组（75例）。对照组给予注射用硝普钠，50 mg与5%葡萄糖注射液500 mL配伍，开始以0.5 μg/(kg·min)静脉滴注，根据反应以0.5 μg/(kg·min)递增至3 μg/(kg·min)，连续应用3 d。治疗组在对照组治疗基础上给予盐酸奥普力农注射液，初始剂量为10 μg/kg，缓慢静脉注射5 min，随后以0.1～0.3 μg/kg·min的剂量静脉滴注，必要时以0.4 μg/(kg·min)的剂量增加。两组均治疗3 d。观察两组的临床疗效，比较两组治疗前后心功能指标、血清学指标、QRS积分、心肌梗死面积的变化情况。结果 治疗后，对照组和治疗组的总有效率分别是85.33%、97.33%，两组比较差异具有统计学意义（P<0.05）。治疗后，治疗后两组左心室射血分数（LVEE）显著升高，左室舒张末期内径（LVEDD）、左心室收缩末内径（LVESD）、左心室收缩末期容积（LVESV）显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；治疗后，治疗组LVEE高于对照组，LVEDD、LVESD、LVESV低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组经治疗C反应蛋白（hs-CRP）、氨基末端脑钠肽前体（NT-proBNP）、肌钙蛋白（cTnT）、胱抑素C（Cys-C）、内皮素-1（ET-1）、QRS积分、心肌梗死面积均显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；治疗后，治疗组hs-CRP、NT-proBNP、cTnT、Cys-C、ET-1水平、QRS积分、心肌梗死面积显著低于对照组，两组比较差异有统计学意义（P<0.05）。结论 盐酸奥普力农联合硝普钠治疗急性心力衰竭具有较好的临床疗效，可有效改善患者心功能，降低机体炎症反应，保护心肌细胞受损，有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of olprinone combined with nitroprusside in treatment of senile acute heart failure. Methods 150 Patients with senile acute heart failure in the 175th Hospital of Chinese People's Liberation Army (Southeast Hospital Affiliated to Xiamen University) from May 2014 to May 2017 were divided into control group (75 cases) and treatment group (75 cases) according to the difference of drug use. Patients in the control group were given Sodium Nitroprusside for injection, 50 mg was combined with 5% Glucose Injection 500 mL, and intravenous infusion was started at 0.5 μg/(kg·min). According to the reaction, the infusion was increased by 0.5 μg/(kg·min) to 3 μg/(kg·min), and the application was continued for 3 days. Patients in the treatment group were given Olprinone Hydrochloride Injection on the basis of the control group, the initial dosage was 10 μg/kg, given slowly intravenously for 5 min, followed by intravenous drip at a dosage of 0.1 - 0.3 μg/kg·min, if necessary, at a dosage of 0.4 μg/kg·min. Patients in two groups were treated for 3 d. After treatment, the clinical efficacy was evaluated, and the changes of cardiac function indexes, serological indexes, QRS score, and myocardial infarction area in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment group were 85.33% and 97.33%, and there were differences between two groups (P<0.05). After treatment, LVEE in the two groups were significantly increased, but LVEDD, LVESD, and LVESV were significantly decreased, and there were differences in the same group (P<0.05). After treatment, LVEE in the treatment group was higher than those in the control group, but LVEDD, LVESD, and LVESV were lower than those in the control group, and there were differences between two groups (P<0.05). After treatment, hs-CRP, NT-proBNP, cTnT, Cys-C, ET-1, QRS score, and myocardial infarction area were significantly decreased, and there were differences in the same group (P<0.05). After treatment, hs-CRP, NT-proBNP, cTnT, Cys-C, ET-1, QRS score, and myocardial infarction area were lower than those in the control group, and there were differences between two groups (P<0.05). Conclusion Olprinone combined with nitroprusside has significant clinical effect in treatment of senile acute heart failure, and can effectively improve the heart function, also can reduce the body's inflammatory response, and protect the myocardial cells from damage, which has a certain clinical application value.