伊伐布雷定联合沙库巴曲缬沙坦治疗心力衰竭的临床效果

Clinical effect of ivabradine combined with sacubitril valsartan in the treatment of heart failure

目的探讨伊伐布雷定联合沙库巴曲缬沙坦治疗心力衰竭的临床效果。方法选取2018年6月至2019年12月本院收治的42例心力衰竭患者作为研究对象,遵循随机原则将其分为参照组和研究组,各21例。参照组给予常规抗心力衰竭治疗,研究组给予伊伐布雷定联合沙库巴曲缬沙坦治疗。比较两组的临床疗效、不良反应发生情况、心功能指标、血清学指标水平、免疫功能指标、血生化指标水平。结果研究组的治疗总有效率为95.24%,高于参照组的66.67%,差异具有统计学意义(P<0.05)。研究组的不良反应总发生率为4.76%,低于参照组的28.57%,差异具有统计学意义(P<0.05)。治疗前,两组的SV、LVEF、LVESD、LVEDD、HR比较,差异无统计学意义(P>0.05);治疗后,两组的SV、LVEF均较治疗前升高,LVESD、LVEDD、HR均较治疗前降低,且研究组优于参照组,差异具有统计学意义(P<0.05)。治疗前,两组的NT-proBNP、ALD、ICAM-1水平比较,差异无统计学意义(P>0.05);治疗后,两组的NT-proBNP、ALD、ICAM-1水平均较治疗前降低,且研究组低于参照组,差异具有统计学意义(P<0.05)。治疗前,两组的CD3^(+)、CD4^(+)/CD8^(+)及IgM、IgA、IgG水平比较,差异无统计学意义(P>0.05);治疗后,两组的CD3^(+)、CD4^(+)/CD8^(+)及IgM、IgA、IgG水平均较治疗前升高,且研究组高于参照组,差异具有统计学意义(P<0.05)。治疗前、后,两组的血钾、血钠、血肌酐水平比较,差异均无统计学意义(P>0.05)。结论伊伐布雷定联合沙库巴曲缬沙坦治疗心力衰竭的效果显著,可降低不良反应发生率,改善心功能及免疫功能,降低血清学指标水平,值得临床推广和应用。

Objective To investigate the clinical effect of ivabradine combined with sacubitril valsartan in the treatment of heart failure.Methods A total of 42 patients with heart failure treated in our hospital from June 2018 to December 2019 were selected as the research objects.The patients were divided into reference group and study group follow the random principle,with 21 cases in each group.The reference group was given conventional anti-heart failure treatment,and the study group was given ivabradine combined with sacubitril valsartan treatment.The clinical efficacy,occurrence of adverse reactions,cardiac function indexes,serological indexes level,immune function indexes and blood biochemical indexes level were compared between the two groups.Results The total effective rate of treatment in the study group was 95.24%,which was higher than 66.67%in the reference group,and the difference was statistically significant(P<0.05).The total incidence of adverse reactions in the study group was 4.76%,which was lower than 28.57%in the reference group,and the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in SV,LVEF,LVESD,LVEDD and HR between the two groups(P>0.05);after treatment,SV and LVEF of the two groups were higher than those before treatment,LVESD,LVEDD and HR were lower than those before treatment,and those in the study group were better than the reference group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in the NT-proBNP,ALD and ICAM-1 levels between the two groups(P>0.05);after treatment,the NT-proBNP,ALD and ICAM-1 levels in the two groups were lower than those before treatment,and those in the study group were lower than the reference group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in the CD3^(+),CD4^(+)/CD8^(+)and IgM,IgA and IgG levels between the two groups(P>0.05);after treatment,the CD3^(+),CD4^(+)/CD8^(+)and IgM,IgA and IgG levels in the two groups were higher than those before treatment,and those in the study group were higher than the reference group,the differences were statistically significant(P<0.05).Before and after treatment,there were no significant differences in the blood potassium,blood sodium and blood creatinine levels between the two groups(P>0.05).Conclusion Ivabradine combined with sacubitril valsartan in the treatment of heart failure has a significant effect,which can reduce the incidence of adverse reactions,improve cardiac function and immune function,and reduce the serological indexes level.It is worthy of clinical promotion and application.