沙库巴曲缬沙坦治疗慢性心力衰竭合并糖尿病患者的临床研究

Clinical Study of Sacubitril and Valsartan in the Treatment of Patients with Chronic Heart Failure and Diabetes Mellitus

目的研究沙库巴曲缬沙坦治疗慢性心力衰竭合并糖尿病患者的临床疗效。方法选取2020年1月—2021年1月该院收治的60例慢性心力衰竭合并糖尿病患者作为研究对象,随机数表法将其分为两组,各30例。对照组给予常规对症治疗,观察组在对症治疗基础上增加沙库巴曲缬沙坦治疗,对比两种治疗方案对患者心功能、血糖水平和不良反应发生率的影响。结果两组患者治疗后的心功能指标较治疗前均有显著改善,观察组治疗后的血清N末端脑钠肽前体水平小于对照组,左室射血分数和心输出量均大于对照组,差异有统计学意义(P<0.05);两组治疗后患者的血糖水平较治疗前均有降低,观察组治疗后的空腹血糖、餐后2 h血糖和糖化血红蛋白均显著低于对照组,差异有统计学意义(P<0.05);观察组与对照组患者治疗期间及治疗后的不良反应发生率相比,差异无统计学意义(P>0.05)。结论采用沙库巴曲缬沙坦治疗慢性心力衰竭合并糖尿病的疗效显著,可改善心功能,降低血糖水平,且具备一定的安全性,因此,可进一步推广应用。

Objective To study the clinical efficacy of sacubitril-valsartan in the treatment of chronic heart failure complicated with diabetes.Methods From January 2020 to January 2021,60 patients with chronic heart failure complicated with diabetes who were treated in the hospital were selected as the research objects,and they were divided into two groups according to the random number table,with 30 cases in each group.The control group was given routine symptomatic treatment,and the observation group was given sacubitril-valsartan treatment on the basis of symptomatic treatment.The effects of the two treatment regimens on cardiac function,blood glucose levels and incidence of adverse reactions were compared.Results The cardiac function indexes of the two groups of patients after treatment were significantly improved compared with those before treatment,the serum N-terminal brain natriuretic peptide precursor level of the observation group after treatment was lower than that of the control group,and the left ventricular ejection fraction and cardiac output were greater than those of the control group,the difference was statistically significant(P<0.05).The blood glucose levels of the two groups after treatment were lower than those before treatment,the fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin of the observation group after treatment were significantly lower than those of the control group,the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the observation group and the control group during and after treatment(P>0.05).Conclusion Sacubitril-valsartan has significant curative effect in the treatment of chronic heart failure complicated with diabetes mellitus,can improve cardiac function,reduce blood glucose level,and has certain safety,therefore,it can be further popularized and applied.