沙库巴曲缬沙坦联用法舒地尔治疗冠心病心力衰竭的临床观察

Clinical observation of sacubitrill/valsartan combined with fasudil in the treatment of coronary heart disease heart failure

目的观察沙库巴曲缬沙坦联用法舒地尔治疗冠心病心力衰竭的临床效果。方法选取于延安市人民医院心内科住院的冠心病心力衰竭患者80例,随机分成对照组和观察组各40例,均接受常规治疗,对照组采用沙库巴曲缬沙坦治疗,观察组采用沙库巴曲缬沙坦联用法舒地尔,比较两组患者的临床疗效、治疗前后左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)、血浆脑钠肽(NT-proBNP)、血清可溶性细胞间黏附分子-1(sICAM-1)和血浆内皮微粒(EMPs)水平及不良反应。结果观察组总有效率高于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者LVEDD、LVESD、LVEF、NT-proBNP、EMPs、sICAM-1对比,差异无统计学意义(P>0.05);治疗后,两组患者LVEDD、LVESD、LVEF、NT-proBNP、EMPs、sICAM-1均较本组治疗前明显改善,且观察组改善更显著,差异有统计学意义(P<0.05)。两组患者不良反应发生率低。结论沙库巴曲缬沙坦联用法舒地尔治疗冠心病心力衰竭的临床效果显著,可抑制心肌重塑,降低炎症因子水平,改善心功能,安全性高。

Objective To observe the clinical effect of sacubitrill/valsartan combined with fasudil in the treatment of coronary heart disease heart failure.Methods 80 patients with coronary heart disease heart failure who were hospitalized in our department of cardiology were selected and randomly divided into control group and observation group of 40 cases each.All patients received routine treatment.The control group was treated with sacubitrill/valsartan.The observation group was treated with sacubitrill/valsartan combined with fasudil.The clinical effects,left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left ventricular ejection fraction(LVEF),plasma brain natriuretic peptide(NT-proBNP),serum soluble intercellular adhesion molecule-1(sICAM-1),plasma endothelial particles(EMPs)levels and side effects of the two groups were compared before and after treatment.Results The total effective rate of the observation group was higher than that of the control group.Before treatment,there was no significant difference in LVEDD,LVESD,LVEF,NT-proBNP,EMPs and sICAM-1 between the two groups(P>0.05).After treatment,the LVEDD,LVESD,LVEF,NT-proBNP,EMPs,and sICAM-1 of the two groups of patients were significantly improved compared with those before treatment in this group.The improvement of the observation group was more significant,the difference was statistically significant(P<0.05).The incidence of adverse reactions was low in the two groups.Conclusion Sacubitrill/valsartan combined with fasudil had significant clinical effects in the treatment of coronary heart disease heart failure,which could inhibit myocardial remodeling,reduce inflammatory factor levels,improve heart function,and had high safety.