沙库巴曲缬沙坦治疗老年慢性心功能不全的疗效及机制研究

Study on the efficacy and mechanism of sacubitril valsartan in the treatment of elderly patients with chronic heart failure

目的分析沙库巴曲缬沙坦治疗老年慢性心功能不全的疗效及对病人心功能,血清心肌营养素-1(CT-1)、β-内啡肽(β-EP)水平的影响。方法将我院2019年4月至2020年6月间收治的100例慢性心功能不全病人随机分为观察组和对照组,每组50例。对照组采用常规方案进行治疗,观察组在对照组基础上给予沙库巴曲缬沙坦钠片,观察并评估2组疗效。治疗前后检测并比较病人的心功能指标、6 min步行距离(6MWD)、明尼苏达心力衰竭生活质量问卷(MLHFQ)评分及血清中CT-1、β-EP水平。结果观察组临床总有效率明显高于对照组(94.0%比74.0%),差异有统计学意义(P<0.05)。治疗后,2组LVEF、每搏心输出量(SV)、6MWD和CT-1水平明显高于治疗前,左心室舒张末内径(LVEDD)、MLHFQ评分和β-EP水平明显低于治疗前,且观察组改善更明显,差异均有统计学意义(P<0.01)。结论沙库巴曲缬沙坦治疗老年慢性心功能不全病人可有效提高临床疗效,并改善病人心功能和血清中CT-1、β-EP水平。

Objective To analyze the efficacy of sacubitril valsartan in the treatment of elderly patients with chronic heart failure and the influence on the heart function,serum levels of cardiotrophin-1(CT-1)andβ-endorphin(β-EP).Methods A total of 100 patients with chronic heart failure in our hospital from April 2019 to June 2020 were randomly divided into the observation group and the control group,with 50 cases in each group.The control group was treated with conventional treatment,and the observation group was given sacubitril valsartan sodium tablets on the basis of the control group.The curative effect of the two groups was observed and evaluated.The heart function indexes,6-minute walking distance(6MWD),Minnesota Living with Heart Failure Questionaire(MLHFQ)score,the serum levels of CT-1 andβ-EP before and after the treatment were detected and compared.Results The clinical effective rate of the observation group was significantly higher than that of the control group(94.0%vs 74.0%,P<0.05).After treatment,the levels of left ventricular ejection fraction(LVEF),stroke volume(SV),6MWD and CT-1 were significantly higher and the levels of left ventricular end-diastolic dimension(LVEDD),β-EP score and MLHFQ score were significantly lower in two groups than those before treatment,especially in the observation group(P<0.01).Conclusions Sacubitril valsartan can effectively improve the clinical efficacy,cardiac function and serum levels of CT-1 andβ-EP of the elderly patients with chronic heart failure.