沙库巴曲缬沙坦联合酒石酸美托洛尔对老年慢性心力衰竭患者的应用效果

Effect of Sacubitril valsartan combined with Metoprolol tartrate on elderly patients with chronic heart failure

目的探讨沙库巴曲缬沙坦联合酒石酸美托洛尔对老年慢性心力衰竭(chronic heart failure,CHF)患者的应用效果。方法选取2018年1月至2019年1月西安交通大学第二附属医院和西安医学院第一附属医院收治的76例老年CHF患者为研究对象,采用随机数表法将入选患者分为观察组和对照组,每组各38例。在常规治疗基础上,对照组患者接受缬沙坦联合酒石酸美托洛尔治疗,观察组患者接受沙库巴曲缬沙坦联合酒石酸美托洛尔治疗。两组患者均治疗3个月。比较治疗前后两组患者左心室射血分数(left ventricular ejection fraction,LVEF)、左心室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)、左心室短轴缩短率(fractional shortening,FS)、心输出量(cardiac output,CO)、6 min步行距离、血清N-末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)、生长分化因子(growth differentiation factor,GDF)-15水平和临床疗效。结果治疗后两组患者LVEF、FS、CO均显著高于本组治疗前(均P<0.05),LVEDD均显著小于本组治疗前(均P<0.05),6 min步行距离均显著长于本组治疗前(均P<0.05),血清NT-proBNP、GDF-15水平均显著低于本组治疗前(均P<0.05)。观察组患者治疗后LVEF、FS、CO均显著高于对照组(均P<0.05),LVEDD显著小于对照组(P<0.05),6 min步行距离显著短于对照组(P<0.05),血清NT-proBNP、GDF-15水平均显著低于对照组(均P<0.05)。观察组患者治疗总有效率显著高于对照组(P<0.05)。两组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论沙库巴曲缬沙坦联合酒石酸美托洛尔能显著改善老年CHF患者的心功能,临床疗效显著,安全可靠,值得临床推广应用。

Objective To investigate the effect of Sakubattral valsartan combined with Metoprolol tartrate in treatment of elderly patients with chronic heart failure(CHF).Method Seventy-six elderly patients with CHF admitted to the Second Affiliated Hospital of Xi'an Jiaotong University and the First Affiliated Hospital of Xi'an Medical College from January 2018 to January 2019 were randomly divided into observation group and control group,each group had 38 cases.On the basis of routine treatment,patients in control group were given Valsartan combined with Metoprolol tartrate,and observation group patients were given Sakubattral valsartan combined with Metoprolol tartrate,all patients were treated for 3 months.The left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),fractional shortening(FS),cardiac output(CO),6 minutes walking distance,serum N-terminal pro-brain natriuretic peptide(NT-proBNP),growth differentiation factor(GDF)-15 levels and clinical efficacy were compared between the two groups before and after treatment.Result After treatment,the LVEF,FS,CO in the two groups were significantly higher than those before treatment(all P<0.05),and LVEDD were significantly smaller than that before treatment(all P<0.05),6 minutes walking distances were significantly longer than that before treatment(all P<0.05),the serum levels of NTproBNP and GDF-15 were significantly lower than those before treatment(all P<0.05).The LVEF,FS,CO in observation group after treatment were significantly higher than those of control group(all P<0.05),and LVEDD was significantly smaller than that of control group(P<0.05),6 minutes walking distance was significantly longer than that of control group(P<0.05),the serum levels of NT-proBNP and GDF-15 were significantly lower than those of control group(all P<0.05).The total effective rate of observation group was significantly higher than that of control group(P<0.05).There was no significant difference in the incidence of adverse reaction between the two groups(P>0.05).Conclusion Sakubatra valsartan combined with Metoprolol tartrate can significantly improve the cardiac function of elderly patients with CHF.Its clinical efficacy is outstanding,safe and reliable,which is worthy of clinical application.