沙库巴曲缬沙坦钠联合曲美他嗪对扩张型心肌病患者心肌纤维化及心功能的影响

Effects of Sacubactril Valsartan Sodium Combined with Trimetazidine on Myocardial Fibrosis and Cardiac Function in Patients with Dilated Cardiomyopathy

目的探究沙库巴曲缬沙坦钠联合曲美他嗪对扩张型心肌病患者心肌纤维化及心功能的影响。方法选择2020年3月—2023年3月金乡县人民医院心内科收治的80例扩张型心肌病患者为研究对象,采用随机数字表法将其分为对照组及观察组,每组40例。对照组采用曲美他嗪治疗,观察组在对照组基础上采用沙库巴曲缬沙坦钠治疗,均持续1个月。比较两组患者的临床疗效、心功能、心肌纤维化指标及不良反应发生情况。结果治疗后,观察组的左心室射血分数比对照组高,左心室收缩末期容积及左心室舒张末期容积均比对照组低,组间差异有统计学意义(P<0.05)。治疗后,观察组的层粘连蛋白、Ⅲ型前胶原及血清透明质酸水平均比对照组小,组间差异有统计学意义(P<0.05)。观察组的治疗总有效率为95.00%,比对照组的75.00%高,差异有统计学意义(P<0.05)。两组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论扩张型心肌病患者采用沙库巴曲缬沙坦钠联合曲美他嗪治疗,可明显改善其心肌纤维化情况及心功能,且用药安全性高。

Objective To investigate the effects of sacubactril valsartan sodium combined with trimetazidine on myocardial fibrosis and cardiac function in patients with dilated cardiomyopathy.Methods 80 patients with dilated cardiomyopathy admitted to the Cardiology Department of Jinxiang County People's Hospital from March 2020 to March 2023 were selected as the study objects and were divided into a control group and an observation group by random number table method,with 40 cases in each group.The control group was treated with trimetazidine,and the observation group was treated with sacubactril valsartan sodium on the basis of the control group.Both groups were treated for 1 month.The clinical efficacy,cardiac function,myocardial fibrosis indexes and the occurrence of adverse reactions were compared between the two groups.Results After treatment,the left ventricular ejection fraction of the observation group was higher than that of the control group,and the left ventricular end-systolic volume and left ventricular end-diastolic volume were less than those of the control group,the differences between the groups were statistically significant(P<0.05).After treatment,the levels of laminin,type Ⅲ procollagen and serum hyaluronic acid in the observation group were lower than those in the control group,the differences between the groups were statistically significant(P<0.05).The total effective rate of observation group was 95.00%,which was higher than 75.00%of control group,and the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion The treatment of patients with dilated cardiomyopathy with sacubactril valsartan sodium combined with trimetazidine can significantly improve myocardial fibrosis and cardiac function,and the drug is safe.