目的 分析注射用益氣復脈（凍干）聯(lián)合米力農(nóng)治療急性心肌梗死合并心衰的效果以及對患者血清白細胞介素-6（IL-6）、C反應蛋白（CRP）水平的影響。方法 選取在2020年1月—2021年2月于瀘州市人民醫(yī)院接受治療的90例急性心肌梗死合并心衰患者為研究對象，其中45例選取于接受米力農(nóng)治療的患者，納入對照組；另外45例選取于在對照組治療方式基礎上加用注射用益氣復脈（凍干）治療的患者，納入試驗組。兩組患者均接受一致的基礎治療，包括利尿治療、血管擴張治療、給氧治療等，對照組在基礎治療同時給予米力農(nóng)注射液，劑量為50 μg/kg，將米力農(nóng)注射液與5%葡萄糖注射液10 mL混合后，進行靜脈推注，后以0.5 μg/（kg·min）的速度進行進行靜脈滴注（溶媒為50 mL葡萄糖注射液），每天治療1次，每次持續(xù)治療4～6 h。試驗組在對照組的治療基礎上加用注射用益氣復脈（凍干）5.2 g溶入5%葡萄糖注射液250 mL中進行靜脈滴注，1次/d。兩組患者均接受1周的治療。對比治療前后兩組患者總有效率、心功能指標、心功能NYHA分級及血清IL-6、CRP水平，觀察兩組患者不良反應發(fā)生情況。結果 經(jīng)過治療后，試驗組的總有效率86.67%顯著高于對照組的66.67%（P<0.05），兩組患者的各項考察指標均有所改善（P<0.05），治療后試驗組患者的心功能指標左室射血分數(shù)（LVEF）與左心室短軸縮短率（FS）高于對照組（P<0.05），心功能NYHA分級為Ⅲ級患者的占比、心功能指標左心室收縮末期內(nèi)徑（LVESD）、左心室舒張末期內(nèi)徑（LVEDD）與腦鈉肽（BNP）、血清IL-6與CRP水平顯著低于對照組（P<0.05）。兩組的腹痛與便秘發(fā)生率無顯著差異，肝功能、腎功能主要指標均無顯著差異（P>0.05）。結論 在急性心肌梗死合并心衰患者的治療中，同時使用注射用益氣復脈（凍干）與米力農(nóng)進行治療，能夠有效改善患者的心功能指標與體內(nèi)的炎癥反應，其療效顯著，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