目的 观察伊伐布雷定片联合左西孟旦在急性心肌梗死合并心力衰竭患者中的应用效果。 方法 选择2020年5月1日至2022年12月31日医院收治的78例急性心肌梗死合并心力衰竭患者，采用随机数字表法将其分成对照组（n = 39）与研究组（n = 39）。两组均接受基础治疗，对照组在此基础上接受左西孟旦治疗，研究组在对照组的基础上联合伊伐布雷定片进行治疗。两组治疗周期均为4 周。比较两组患者生命体征、临床疗效、心功能指标、血清学指标、炎症因子及安全性。 结果 两组治疗后收缩压、舒张压、心率均降低（P < 0.05），且相比对照组，研究组收缩压、心率、舒张压、心率明显降低（P < 0.05）。与对照组相比，研究组总有效率明显较高（P < 0.05）。两组治疗后CO、LVEF水平上升（P < 0.05），LVEDV、LVESV水平下降（P < 0.05），且与对照组比较，研究组CO、LVEF水平更高（P < 0.05），LVEDV、LVESV水平更低（P < 0.05）。两组治疗后cTnI、sST2、NT-proBNP水平均下降（P < 0.05），且与对照组比较，研究组血清cTnI、sST2、NT-proBNP水平明显下降（P < 0.05）。两组治疗后肿瘤坏死因子-α（TNF-α）、髓过氧化物酶（MPO）及高敏C反应蛋白（hs-CRP）均降低（P < 0.05），且研究组更低（P < 0.05），且研究组血清hs-CRP、MPO及TNF-α水平较对照组明显下降（P < 0.05）。两组不良反应总发生率对比无明显差异（P > 0.05）。 结论 左西孟旦联合伊伐布雷定片可改善急性心肌梗死合并心力衰竭患者的心功能，减轻炎症反应，疗效确切，调节血清sST2、cTnI、NT-proBNP水平，且安全可靠。

Objective To observe the efficacy of ivabradine combined with levosimendan in patients with acute myocardial infarction complicated with heart failure. Methods A total of 78 patients with acute myocardial infarction complicated with heart failure admitted to the hospital from May 1， 2020 to December 31， 2022 were selected and divided into control group （n = 39） and study group （n = 39） by random number table method. In addition to basic treatment，the control group received levosimendan， and the study group ivabradine and levosimendan. The treatment period of both groups was 4 weeks. Compare two groups of patients' vital signs， clinical curative effect and heart function index， serological indexes， inflammatory factors and security. Results Compared with before treatment， the systolic blood pressure， diastolic blood pressure and heart rate of the two groups were decreased after treatment （P < 0.05）， and the systolic blood pressure， heart rate， diastolic blood pressure and heart rate of the study group were significantly decreased compared with the control group （P < 0.05）. Compared with the control group， the total effective rate of the study group was significantly higher （P < 0.05）. Compared with before treatment， the levels of CO and LVEF were increased （P < 0.05）， while the levels of LVEDV and LVESV were decreased （P < 0.05）. Compared with the control group， the levels of CO and LVEF in the study group were higher （P < 0.05）， and the levels of LVEDV and LVESV in the study group were lower （P < 0.05）. Compared with before treatment， the levels of cTnI， sST2 and NT-proBNP in both groups were decreased after treatment （P < 0.05）， and the serum levels of cTnI， sST2 and NT-proBNP in the study group were significantly decreased compared with the control group （P < 0.05）. Tumor necrosis factor α （TNF-α）， myeloperoxidase （MPO） and highly sensitive C-reactive protein （hs-CRP） were all decreased after treatment in the two groups （P < 0.05）， and those in the study group were much lower （P < 0.05）No difference between the incidence of adverse reactions to the total contrast the two groups （P > 0.05）. Conclusion Levosimendan combined with ivabadinehave a definite effect on patients with acute myocardial infarction complicated with heart failure for the improved cardiac function， reduced inflammation， regulated serum sST2， cTnI， and NT-proBNP level. It is also safe and reliable