Objective To investigate the clinical effects of rh BNP combined with levosimendan on patients with acute myocardial infarction（AMI） combined with cardiogenic shock（CS）

and the effects on the patients’ cardiac pump function

pulse-indicated continuous cardiac output（PICCO） hemodynamic indexes

myocardial function

and serum arginine-vasopressin（AVP） and angiotensin Ⅱ（AngⅡ） levels. Methods One hundred and seventyseven patients with AMI combined with CS admitted to a hospital in Kaifeng from January 2017 to January 2020 were selected for the study and divided into a control group

a study group and a combined group according to different treatment protocols

59 cases each. Patients in the control group were treated with rh BNP

patients in the study group were treated with levosimendan

and patients in the combined group were treated with rh BNP combined with levosimendan

all for 7 d. The treatment effects of the three groups were compared

and patients in the three groups were compared in terms of cardiac pumping function [stroke volume（SV）

left ventricular ejection fraction（LVEF）

cardiac index（CI）]

PICCO hemodynamic parameters [central venous pressure（CVP）

systemic vascular resistance index（SVRI）

pulmonary capillary wedge pressure（PCWP）]

myocardial function [serum cardiac troponin I（cTnI）

creatine kinase myocardial band（CK-MB）

wall motion score index（WMSI）

longitudinal peak systolic strain rates（SRs）] and serum AVP and AngⅡ levels before treatment

at 3 d and at 7 d. The occurrence of major adverse cardiac events（MACE） in the three groups were compared at 6 months of follow-up. Results The total treatment efficacy of patients in the combined group was 93.22%

which was higher than that of the control group（79.66%） and the study group（76.27%）

and the differences were statistically significant（P<0.05）. Before treatment

there were no statistically significant differences in SV

LVEF

CI

WMSI and SRs among the 3 groups（P>0.05）; at 3 d and 7 d of treatment

SV

LVEF

CI

WMSI and SRs of the 3 groups were higher than before treatment

and the combined group had higher figures than the control group and the study group

with statistically significant differences（P<0.05）; the levels of WMSI were lower than before treatment

and the figures for the combined group was lower than those for the control group and the study group

with statistically significant differences（P <0.05）. Before treatment

the differences in CVP

SVRI and PCWP were not statistically significant（P>0.05）; at 3 d and 7 d of treatment

CVP

SVRI and PCWP were lower than before treatment in all three groups

and the combined group had lower figures than the control group and the study group

with statistically significant differences（P<0.05）. Before treatment

there was no statistically significant difference in the levels of serum c TnI

CK-MB among the three groups; at 3 d and 7 d of treatment

the levels of serum c TnI

CK-MB and WMSI in the three groups were lower than before treatment

and the combined group had lower figures than the control group and the study group

with statistically significant differences（P<0.05）.Before treatment

there was no statistically significant difference in the levels of serum AVP and AngⅡ among the three groups（P>0.05）; at 3 d and 7 d of treatment

the levels of serum AVP and AngⅡ in the three groups were lower than before treatment

and the combined group had lower figures than the control group and the study group

with statistically significant differences（P<0.05）.At the 6-month follow-up

the incidence of MACE was 6.78% in the combined group

which was lower than that of 20.34% in the control group and 23.73% in the study group

and the differences were statistically significant（P<0.05）. Conclusion Treating AMI combined with CS with the combination therapy of rh BNP and levosimendan is effective and can significantly improve the pump function and myocardial function of patients

reduce the PICCO hemodynamic index and serum AVP and AngⅡ levels

while also lowering the incidence of MACE

and it is worth promoting in clinical use.