沙库巴曲缬沙坦联合美托洛尔治疗慢性心力衰竭的临床观察

Clinical efficacy of combined sacubitril-valsartan and metoprolol in chronic heart failure

目的观察沙库巴曲缬沙坦联合美托洛尔缓释片治疗慢性心力衰竭(CHF)的临床效果。方法选取2017年11月~2019年2月于解放军联勤保障部队第九二〇医院就诊的119例CHF患者,根据药物治疗方案不同分成对照组(59例)和治疗组(60例)。对照组患者口服琥珀酸美托洛尔缓释片;治疗组患者在对照组基础上加用沙库巴曲缬沙坦钠片。治疗8周后比较两组疗效、6 min步行距离、明尼苏达生活量表(MLHFQ)评分、血清标志物N端B型脑钠肽前体(NT-proBNP)、血清细胞间黏附分子-1(ICAM-1)及醛固酮(ALD)、心功能指标左室射血分数(LVEF)、短轴缩短率(LVFS)及不良反应。结果连续治疗8周后治疗组疗效、6 min步行距离、LVEF、LVFS高于对照组(P<0.01),而NT-proBNP、ICAM-1、ALD、MLHFQ评分低于对照组,差异有统计学意义(P<0.01)。结论沙库巴曲缬沙坦联合美托洛尔缓释片治疗CHF效果显著且无明显不良反应。

Objective To observe the clinical efficacy of combined sacubitril-valsartan and metoprolol in chronic heart failure(CHF).Methods 119 patients with chronic heart failure were randomly divided into control(59 cases)and treatment(60 cases)groups according to type of drug application.Patients in the control group were po administered with metoprolol.Patients in the treatment group were po administered with sacubitril-valsartan on the basis of the control group.Clinical efficacy,6-min walking distance,serum markers,cardiac function,adverse reactions and quality of life(QoL)were compared between 2 groups after 8 weeks.Results After treatment,clinical efficacy,6-min walking distance,and left ventricular ejection fraction and fraction shortening were increased(P<0.01)compared with control group,while MLHFQ score and serum levels of intercellular adhesion molecule-1,NT-proBNP and aldosterone decreased in treatment group(P<0.01).Conclusion Combined sacubitril-valsartan and metoprolol is safe and effective in the treatment of CHF,which can improve cardiac function and quality of life.