【摘要】 目的 分析缺血性心肌病致心力衰竭患者联合使用注射用重组人脑利钠肽及左西孟旦对肺毛细血管楔压(PCWP)、肺动脉压(PAP)水平及心肌细胞功能的影响。方法 选择160例于2021年4月至2023年4月就诊在安阳市人民医院收治的缺血性心肌病致心力衰竭患者，对其行随机方法，使用方法为随机数字表法，分组结果为患者分别进入例数为80例的联合组和对照组。对照组接受左西孟旦等基础治疗，联合组在对照组基础上接受重组人脑利钠肽联合治疗。比较两组疗效。比较两组治疗前后血流动力学参数、心肌细胞功能、心功能、药物不良反应发生情况。结果 联合组治疗总有效率达93.75%,同对照组相比较更高(P<0.05)。两组PCWP、PAP及氨基末端脑钠肽前体(NT-proBNP)水平同治疗前相较均下降，且联合组相对更低(P<0.05)。两组左心射血分数(LVEF)同治疗前相较升高，左心收缩末期内径(LVESD)及左心舒张末期内径(LVEDD)通治疗前相较下降，且联合组LVEF水平相对更高，LVESD及LVEDD则相对更低(P<0.05)。联合组治疗后1个月内不良反应发生率为10.00%,较对照组不良反应总发生率差异无统计学意义(P>0.05)。结论 缺血性心肌病致心力衰竭患者联合应用重组人脑利钠肽及左西孟旦，其PCWP、PAP水平及心肌细胞功能的调节效果均得到增强，增强患者心功能改善效果，且不增加药物不良反应发生风险。更多还原

【Abstract】 Objective To observe the effects of recombinant human brain natriuretic peptide and levosimendan on pulmonary capillary wedge pressure(PCWP), pulmonary arterial pressure(PAP) levels, and myocardial cell function in patients with ischemic cardiomyopathy induced heart failure.Methods A total of 160 patients with heart failure caused by ischemic cardiomyopathy who were admitted to the hospital from April 2021 to April 2023 were selected, and the random method was used, and the group results were that the patients entered the combination group and the control group with 80 cases, respectively. The control group received basic treatment such as levosimendan, and the combined group received combined treatment of recombinant human brain natriuretic peptide on the basis of the control group. The efficacy, hemodynamic parameters, myocardial cell function and cardiac function were compared between the groups. The incidence of adverse reactions was calculated.Results After treatment, The total effective rate of the combination group was 93.75%, which was higher than that of the control group(P<0.05). The PCWP, PAP and N-terminal pro-brain natriuretic peptide(NT-proBNP) levels in the two groups were reduced, and these indicators in the combination group were lower than those in the control group(P<0.05). The left ventricular ejection fraction(LVEF) of the two groups was higher than that before treatment, and the left ventricular end systolic diameter(LVESD) and left ventricular end diastolic diameter(LVEDD) levels were lower than that before treatment, while the LVEF level in the combined group was relatively higher, while the level of LVESD and LVEDD was relatively lower(P<0.05). The incidence of adverse reactions in the combination group was 10.00% within one month after treatment, which was not statistically significant compared with the total incidence of adverse reactions in the control group(P>0.05).Conclusion Lyophilized recombinant human brain natriuretic peptide combined with levosimendan can help regulate PCWP, PAP and myocardial cell function in patients with heart failure caused by ischemic cardiomyopathy, and improve cardiac function, without increasing the risk of adverse drug reactions.更多还原