目的 探討托伐普坦片聯(lián)合馬來酸桂哌齊特注射液治療急性心力衰竭的臨床療效。方法 選取2015年4月—2017年4月天津市泰達醫(yī)院收治的急性心力衰竭患者86例為研究對象，所有患者在隨機分組原則下分為對照組和治療組，每組各43例。對照組靜脈滴注馬來酸桂哌齊特注射液，40 mL加入到生理鹽水500 mL中，1次/d。治療組在對照組基礎(chǔ)上口服托伐普坦片，1片/次，1次/d。兩組患者均連續(xù)治療15 d。觀察兩組的臨床療效，比較兩組的心功能、腎功能和心衰指標。結(jié)果 治療后，對照組和治療組的總有效率分別為76.74%、95.35%，兩組比較差異有統(tǒng)計學意義（P<0.05）。治療后，兩組左心室射血分數(shù)（LVEF）、左心室舒張末期內(nèi)徑（LVEDD）、腎小球濾過率（GFR）和尿量均顯著升高，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且治療組這些觀察指標明顯高于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。治療后，兩組N端前腦鈉肽（NT-proBNP）、肌酸激酶同工酶（CK-MB）和心肌肌鈣蛋白（cTnI）水平均顯著降低，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且治療組這些觀察指標明顯低于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。結(jié)論 托伐普坦片聯(lián)合馬來酸桂哌齊特注射液治療急性心力衰竭具有較好的臨床療效，可改善心功能和腎功能，調(diào)節(jié)NT-proBNP、CK-MB和cTnI水平，安全性較好，具有一定的臨床推廣應用價值。

Objective To investigate the clinical effect of Tolvaptan Tablets combined with Cinepazide Maleate Injection in treatment of acute heart failure. Methods Patients (86 cases) with acute heart failure in Tianjin TEDA Hospital from April 2014 to April 2017 were randomly divided into control and treatment groups, and each group had 43 cases. Patients in the control group were iv administered with Cinepazide Maleate Injection, 40 mL added into normal saline 500 mL, once daily. Patients in the treatment group were po administered with Tolvaptan Tablets on the basis of the control group, 1 tablet/time, once daily. Patients in two groups were treated for 15 d. After treatment, the clinical efficacies were evaluated, and cardiac function, renal function, and heart failure indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 76.74% and 95.35%, respectively, and there was difference between two groups (P < 0.05). After treatment, LVEF, LVEDD, GFR, urine volume in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the levels of NT-proBNP, CK-MB, and cTnI in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Tolvaptan Tablets combined with Cinepazide Maleate Injection has clinical curative effect in treatment of acute heart failure, can improve cardiac function and renal function, regulate the levels of NT-proBNP, CK-MB, and cTnI, with good safety, which has a certain clinical application value.