目的 探討托拉塞米聯(lián)合烏拉地爾治療慢性心力衰竭的臨床療效。方法 選取2019年1月—2021年1月在寶雞高新醫(yī)院住院治療的96例慢性心力衰竭患者，隨機(jī)分為對(duì)照組（48例）和治療組（48例）。對(duì)照組靜脈滴注烏拉地爾注射液，25 mg加入生理鹽水100 mL，1次/d。治療組患者在對(duì)照組的基礎(chǔ)上口服托拉塞米片，10 mg/次，1次/d。兩組患者連續(xù)治療7 d。觀察兩組患者臨床療效，比較治療前后兩組患者臨床癥狀緩解時(shí)間，心功能指標(biāo)左室舒張末期內(nèi)徑（LVEDD）、左室射血分?jǐn)?shù)（LVEF）和腦鈉肽（BNP）水平，血清炎性因子白細(xì)胞介素6（IL-6）、白細(xì)胞介素10（IL-10）、腫瘤壞死因子α（TNF-α）和C反應(yīng)蛋白（CRP）水平及不良反應(yīng)情況。結(jié)果 治療后，治療組患者總有效率明顯高于對(duì)照組（97.92%vs 81.25%，P<0.05）。治療后，治療組患者癥狀緩解時(shí)間均早于對(duì)照組（P<0.05）。治療后，兩組患者LVEDD、BNP指標(biāo)明顯下降，而LVEF明顯升高（P<0.05），且治療組患者心功能指標(biāo)水平明顯好于對(duì)照組（P<0.05）。治療后，兩組患者IL-6、TNF-α、CRP水平明顯降低，而IL-10水平明顯升高（P<0.05），且治療組患者炎性因子水平明顯好于對(duì)照組（P<0.05）。治療組藥物不良反應(yīng)發(fā)生率明顯低于對(duì)照組（8.33%vs 16.67%，P<0.05）。結(jié)論 托拉塞米聯(lián)合烏拉地爾治療慢性心力衰竭臨床效果較好，能增強(qiáng)患者心功能，并有效抑制炎性因子釋放，降低不良反應(yīng)發(fā)生率。

Objective To investigate the efficacy of torasemide combined with urapidil in treatment of chronic heart failure. Methods Patients (136 cases) with chronic heart failure in Baoji High Tech Hospital from January 2019 to January 2021 were randomly divided into control (48 cases) and treatment (48 cases) groups. Patients in the control group were iv administered with Urapidil Injection, 25 mg added into 100 mL normal saline, once daily. Patients in the treatment group were po administered with Torsemide Tablets, 10 mg/time, once daily. Patients in two groups were treated for 7 d. After treatment, the clinical evaluation was evaluated, the relief time of clinical symptom, the levels of cardiac function indicators LVEDD, BNP, and LVEF, the levels of inflammatory factors IL-6, TNF-α, CRP, and IL-10, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was significantly higher than that of the control group (97.92% vs 81.25%, P<0.05). After treatment, the time of symptom relief in the treatment group was earlier than that in the control group (P<0.05). After treatment, the indexes of LVEDD and BNP were significantly decreased, while LVEF were significantly increased in two groups (P<0.05), and the level of cardiac function in the treatment group was significantly better than that in the control group (P<0.05). After treatment, the levels of IL-6, TNF-α and CRP in two groups were significantly decreased, while the level of IL-10 were significantly increased (P<0.05), and the level of inflammatory factors in the treatment group was significantly better than that in the control group (P<0.05). The incidence of adverse drug reactions in the treatment group was significantly lower than that in the control group (8.33% vs 16.67%, P<0.05). Conclusion The clinical effect of torasemide combined with urapidil in treatment of chronic heart failure is good, which can enhance the cardiac function of the patients, effectively inhibit the release of inflammatory factors and reduce the incidence of adverse reactions

R972

空軍軍醫(yī)大學(xué)第一附屬醫(yī)院學(xué)科助推計(jì)劃項(xiàng)目（XJZT18MJ40）