目的 探討注射用益氣復(fù)脈（凍干）聯(lián)合重組人腦利鈉肽治療心房顫動伴慢性心力衰竭患者的臨床療效。方法 回顧性收集2018年9月—2020月12月在貴州醫(yī)科大學(xué)附屬烏當(dāng)醫(yī)院心血管內(nèi)科住院的房顫伴慢性心衰患者203例為研究對象，按治療方法不同將患者分為對照組（n=97）和聯(lián)合組（n=106）。所有入組的患者均進(jìn)行常規(guī)的抗心衰治療。對照組患者在常規(guī)治療的基礎(chǔ)上給予注射用重組人腦利鈉肽，首次給藥劑量為0.15 μg/kg、iv給藥，后以0.075 μg/（kg·min）的速度，持續(xù)靜脈泵入72 h。聯(lián)合組在對照組治療的基礎(chǔ)上加用注射用益氣復(fù)脈（凍干）5.2 g藥液溶至5%葡萄糖注射液250 mL中，靜脈滴注，1次/d，連續(xù)治療14 d。治療1個月后對兩組患者進(jìn)行療效評價及腦利鈉肽（BNP）、左室射血分?jǐn)?shù)（LVEF）、6分鐘步行試驗(yàn)（6MWT）檢測。結(jié)果 聯(lián)合組的臨床治療總有效率為81.1%，明顯高于對照組的67.0%（P<0.05）。治療前兩組患者BNP、LVEF、6MWT差異無統(tǒng)計學(xué)意義（P>0.05），經(jīng)治療后各組上述指標(biāo)與治療前比差異有統(tǒng)計學(xué)意義（P<0.05）。治療后聯(lián)合組BNP下降更為明顯（P<0.05），LVEF升高更明顯（P<0.05），6WMT增加更明顯（P<0.05）。結(jié)論 注射用益氣復(fù)脈（凍干）聯(lián)合重組人腦利鈉肽治療心房顫動伴慢性心力衰竭患者可明顯提高患者臨床總有效率，對患者LVEF、6MWT及BNP有明顯的改善作用。

Objective To investigate the clinical efficacy of Yiqi Fumai Lyophilized Injection combined with recombinant human brain natriuretic peptide in treatment of atrial fibrillation with chronic heart failure. Methods Total 203 patients with atrial fibrillation and chronic heart failure hospitalized in the Department of Cardiology, Wudang Hospital Affiliated to Guizhou Medical University from September 2018 to December 2020 were collected retrospectively. According to different treatment methods, the patients were divided into control group (n=97) and combined group (n=106). All patients were treated with routine anti heart failure treatment. The patients in the control group were given recombinant human brain natriuretic peptide for injection on the basis of routine treatment, and the first dose was 0.15 μg/kg intravenously, followed by 0.075 μg/(kg·min) for 72 hours. On the basis of the treatment of the control group, patients in the combined group added 5.2 g of Yiqi Fumai Lyophilized Injection for injection into 250 mL of 5% glucose injection, intravenous drip, once a day, for 14 days. One month after treatment, the curative effect of the two groups were evaluated and brain natriuretic peptide (BNP), left ventricular ejection fraction (LVEF) and 6-minute walking distance (6MWT) were measured. The total clinical effective rates of the two groups were compared by binary logistic regression analysis. Results The total effective rate of the combined group was 81.1%, which was significantly higher than 67.0% in the control group (P<0.05). Before treatment, there was significant difference in BNP, LVEF and 6MWT between the two groups (P<0.05). Before treatment, there was no significant difference in BNP, LVEF, and 6MWT between the two groups of patients (P>0.05). After treatment, the above indexes in each group were significantly different from those before treatment (P<0.05). There was significant difference in BNP level between the two groups after treatment, and BNP decreased more significantly in the combined group after treatment (P<0.05). There was significant difference in LVEF between the two groups after treatment, and LVEF increased more significantly in the combined group (P<0.05). There was significant difference in 6MWT between the two groups after treatment, and the increase of 6wmt in the combined group was more obvious after treatment (P<0.05). Conclusion Yiqi Fumai Lyophilized Injection combined with recombinant human brain natriuretic peptide can significantly improve the total clinical effective rate of patients with atrial fibrillation and chronic heart failure, and can significantly improve LVEF, 6MWT and BNP.

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