目的 分析注射用益气复脉（冻干）联合米力农治疗急性心肌梗死合并心衰的效果以及对患者血清白细胞介素-6（IL-6）、C反应蛋白（CRP）水平的影响。方法 选取在2020年1月—2021年2月于泸州市人民医院接受治疗的90例急性心肌梗死合并心衰患者为研究对象，其中45例选取于接受米力农治疗的患者，纳入对照组；另外45例选取于在对照组治疗方式基础上加用注射用益气复脉（冻干）治疗的患者，纳入试验组。两组患者均接受一致的基础治疗，包括利尿治疗、血管扩张治疗、给氧治疗等，对照组在基础治疗同时给予米力农注射液，剂量为50 μg/kg，将米力农注射液与5%葡萄糖注射液10 mL混合后，进行静脉推注，后以0.5 μg/（kg·min）的速度进行进行静脉滴注（溶媒为50 mL葡萄糖注射液），每天治疗1次，每次持续治疗4～6 h。试验组在对照组的治疗基础上加用注射用益气复脉（冻干）5.2 g溶入5%葡萄糖注射液250 mL中进行静脉滴注，1次/d。两组患者均接受1周的治疗。对比治疗前后两组患者总有效率、心功能指标、心功能NYHA分级及血清IL-6、CRP水平，观察两组患者不良反应发生情况。结果 经过治疗后，试验组的总有效率86.67%显著高于对照组的66.67%（P<0.05），两组患者的各项考察指标均有所改善（P<0.05），治疗后试验组患者的心功能指标左室射血分数（LVEF）与左心室短轴缩短率（FS）高于对照组（P<0.05），心功能NYHA分级为Ⅲ级患者的占比、心功能指标左心室收缩末期内径（LVESD）、左心室舒张末期内径（LVEDD）与脑钠肽（BNP）、血清IL-6与CRP水平显著低于对照组（P<0.05）。两组的腹痛与便秘发生率无显著差异，肝功能、肾功能主要指标均无显著差异（P>0.05）。结论 在急性心肌梗死合并心衰患者的治疗中，同时使用注射用益气复脉（冻干）与米力农进行治疗，能够有效改善患者的心功能指标与体内的炎症反应，其疗效显著，且安全性高。

Objective To analyze the effect of Yiqi Fumai Lyophilized Injection combined with milrinone in the treatment of acute myocardial infarction complicated with heart failure and its effect on the levels of serum interleukin-6 (IL-6) and C-reactive protein (CRP). Methods Total 90 patients with acute myocardial infarction complicated with heart failure treated in Luzhou people's Hospital from January 2020 to February 2021 were selected as the research object, of which 45 patients treated with milrinone were included in the control group, the other 45 patients who were treated with Yiqi Fumai Lyophilized Injection on the basis of the treatment of the control group were included in the experimental group. The patients in both groups received consistent basic treatment, including diuretic treatment, vasodilation treatment and oxygen therapy. The patients in the control group were given milrinone injection at a dose of 50 μg/kg, 10 mL of milrinone injection and 5% glucose injection were mixed and injected intravenously, and then 0.5 μg/(kg·min) for intravenous drip (the solvent is 50 mL glucose injection), once a day for 4-6 hours each time. On the basis of the treatment of the control group, the experimental group added 5.2 g of Yiqi Fumai Lyophilized Injection in dissolved in 250 mL of 5% glucose injection for intravenous drip, once a day. Both groups were treated for one week. The total effective rate, cardiac function index, NYHA grade of cardiac function and the levels of serum IL-6 and CRP were compared between the two groups before and after treatment. Results After treatment, the total effective rate of the experimental group was 86.67%, which was significantly higher than 66.67% of the control group (P<0.05). All the indexes of the two groups were improved (P<0.05). After treatment, the cardiac function indexes left ventricular ejection fraction (LVEF) and left ventricular short axis shortening (FS) of the experimental group were higher than those of the control group (P<0.05). The proportion of patients with NYHA grade III of cardiac function, cardiac function indexes left ventricular end systolic diameter (LVESD), left ventricular end diastolic diameter (LVEDD), brain natriuretic peptide (BNP), serum IL-6 and CRP were significantly lower than those in the control group (P<0.05). There was no significant difference in the incidence of abdominal pain and constipation, and there was no significant difference in the main indexes of liver function and renal function between the two groups (P>0.05). Conclusion In the treatment of patients with acute myocardial infarction complicated with heart failure, the use of Yiqi Fumai Lyophilized Injection and milrinone can effectively improve the indexes of cardiac function and inflammatory reaction in patients, with significant curative effect and high safety.

R971