漆文 彭伟 肖晨亮

【摘要】 目的：探讨依那普利联合丹红注射液治疗慢性心力衰竭（CHF）合并心律失常的效果及对患者心功能、氧化应激水平、血清炎症因子的影响。方法：选择本院2018年6月-2020年5月收治的CHF合并心律失常患者88例，采用随机数字表法将患者分为对照组和观察组，各44例。对照组给予依那普利治疗，观察组给予依那普利联合丹红注射液治疗。比较两组治疗前后心功能（LVEF、LVEDD、HR）、6 min步行试验、氧化应激因子（NO、MDA、SOD）、血清炎症因子（NT-proBNP、hs-CRP、IL-6）变化及临床效果。结果：治疗前，两组心功能、6 min步行试验、氧化应激及血清炎症因子指标比较，差异均无统计学意义（P>0.05）;治疗后，两组LVEF、SOD均升高，LVEDD、HR、NO、MDA、NT-proBNP、hs-CRP、IL-6均降低，6 min步行试验分级均明显改善（P<0.05）;观察组治疗后LVEF、SOD均高于对照组，LVEDD、HR、NO、MDA、NT-proBNP、hs-CRP、IL-6均低于对照组，6 min步行试验分级优于对照组（P<0.05）;观察组治疗心律失常的总有效率为93.18%，明显高于对照组75.00%（P<0.05）;观察组治疗心衰的总有效率95.45%明显高于对照组77.27%（P<0.05）;两组临床均无明显不良反应发生。结论：依那普利联合丹红注射液可顯著改善CHF合并心律失常患者心功能，提高抗氧化能力，降低血清炎症反应，临床疗效显著，无明显不良反应，值得在CHF合并心律失常的临床治疗中进一步推广和应用。

【关键词】 依那普利 丹红注射液 慢性心力衰竭 心律失常 心功能 氧化应激 炎症因子 安全性

Effects of Enalapril Combined with Danhong Injection on Cardiac Function and Safety in Patients with Chronic Heart Failure Complicated with Arrhythmia/QI Wen， PENG Wei， XIAO Chenliang. //Medical Innovation of China， 2021， 18（32）： 0-047

[Abstract] Objective： To investigate the effect of Enalapril combined with Danhong Injection in the treatment of chronic heart failure （CHF） with arrhythmia and its effects on cardiac function， oxidative stress level and serum inflammatory factors. Method： A total of 88 patients with CHF complicated with arrhythmia admitted to our hospital from June 2018 to May 2020 were selected， they were divided into control group and observation group by random number table method， with 44 cases in each group. The control group was treated with Enalapril， and the observation group was treated with Enalapril combined with Danhong Injection. The changes of cardiac function （LVEF， LVEDD， HR）， 6 min walking test， oxidative stress factors （NO， MDA， SOD）， serum inflammatory factors （NT-proBNP， hs-CRP， IL-6） were compared before and after treatment and clinical effects between the two groups. Result： Before treatment， there were no significant differences in cardiac function， 6 min walking test， oxidative stress and serum inflammatory factors between the two groups （P>0.05）; after treatment， LVEF and SOD were increased， LVEDD， HR， NO， MDA， NT-proBNP， hs-CRP and IL-6 were decreased in both groups， and the 6 min walking test grade were significantly improved （P<0.05）; after treatment， LVEF and SOD in the observation group were higher than those in the control group， LVEDD， HR， NO， MDA， NT-proBNP， hs-CRP and IL-6 were lower than those in the control group， and the 6 min walking test grading was better than that in the control group （P<0.05）; the total effective rate of arrhythmia in the observation group was 93.18%， significantly higher than 75.00% in the control group （P<0.05）; the total effective rate of heart failure in the observation group was 95.45%， higher than 77.27% of the control group （P<0.05）; there were no obvious adverse reactions in both groups. Conclusion： Enalapril combined with Danhong Injection can significantly improve cardiac function， enhance antioxidant capacity and reduce serum inflammatory response in patients with CHF complicated with arrhythmia， with significant clinical efficacy and no obvious adverse reactions， which is worthy of further promotion and application in the clinical treatment of CHF complicated with arrhythmia.

[Key words] Enalapril Danhong Injection Chronic heart failure Arrhythmia Cardiac function Oxidative stress Inflammatory factor Safety

First-author’s address： Yifeng County People’s Hospital， Yifeng 336300， China

doi：10.3969/j.issn.1674-4985.2021.32.011

慢性心力衰竭（CHF）是临床常见病和多发病，好发于老年人群，CHF的病因主要是由各种心肌病、慢性炎症反应、自由基代谢紊乱、血流动力学超负荷等多种因素导致的心肌结构和功能改变，是心血管疾病的严重和终末阶段，CHF可引发心律失常，从而进一步加重患者病情[1-2]。……