沙库巴曲缬沙坦联合曲美他嗪治疗慢性充血性心力衰竭临床疗效观察

Therapeatic effect of Sacubitril Valsartan combined with Trimetazidine on chronic congestive heart failure

目的探讨沙库巴曲缬沙坦联合曲美他嗪治疗慢性充血性心力衰竭的临床疗效和安全性。方法选取云南省第二人民医院心内科2018年1-6月收治的慢性充血性心力衰竭患者200例,随机分为观察组和对照组各100例。对照组给予常规抗心力衰竭治疗,观察组在常规抗心力衰竭治疗基础上加用沙库巴曲缬沙坦和曲美他嗪,连续治疗6个月。记录两组治疗前及治疗6个月后左室舒张末内径(LVEDD)、左室射血分数(LVEF)、血浆N-末端脑钠肽(NT-proBNP)、6分钟步行试验(6MWT),记录研究期间住院次数、每次住院时间及不良反应。结果沙库巴曲缬沙坦联合曲美他嗪治疗6个月后与对照组比较,心力衰竭患者LVEF增加[(51.72±8.97)%vs.(43.25±8.01)%,P<0.01],NT-proBNP下降[(386.73±45.41)pg/mL vs.(658.95±76.03)pg/mL,P<0.05],6MWT距离延长[(353.15±12.99)m vs.(305.29±9.92)m,P<0.05],住院次数减少[(1.40±0.57)vs.(1.75±0.74),P<0.01],平均住院时间缩短[(9.85±2.22)d vs.(12.93±3.40)d,P<0.01],不良反应无明显差异(P>0.05)。结论沙库巴曲缬沙坦联合曲美他嗪能显著改善慢性充血性心力衰竭患者的心功能,且安全性良好。

Objective To analyse the effect and safety of Sacubitril Valsartan combined with Trimetazidine on cardiac function in patients with chronic congestive heart failure.Methods 200 cases of patients with chronic congestive heart failure in the department of cardiology of Yunnan No.2 People′s Hospital from January 2018 to June 2018 were randomized into the observation group and the control group,each of which had 100 people.The patients in the control group were treated with routine anti-heart failure treatment.The observation group was treated with Sacubitril Valsartan and Trimetazidine on the basis of routine anti-heart failure treatment.All patients were treated for 6 months.Left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),plasma N-terminal pro-brain natriuretic peptide(NT-proBNP),six-minutes walk test(6MWT)were recorded before and after treatment in both groups.The times of hospitalizations,average hospital stays and adverse reactions were recorded during the study period.Results Compared with the control group,the LVEF increased[(51.72±8.97)% vs.(43.25±8.01)%,P<0.01],the NT-proBNP decreased[(386.73±45.41)pg/mL vs.(658.95±76.03)pg/mL,P<0.05],the 6MWT prolonged[(353.15±12.99)m vs.(305.29±9.92)m,P<0.05],times of hospitalizations reduced[(1.40±0.57)vs.(1.75±0.74),P<0.01],average hospital stays decreased[(9.85±2.22)d vs.(12.93±3.40)d,P<0.01]in patients with heart failure after 6 months of treatment,but there was no significant difference in adverse reactions(P>0.05).Conclusion The cardiac function of patients with chronic congestive heart failure was significantly improved by Sacubitril Valsartan and Trimetazidine,and the safety was good.