尼可地尔联合沙库巴曲缬沙坦治疗慢性心力衰竭的疗效观察

Clinical Effectiveness of Nicorandil Combined with Sacubitril Valsartan Sodium Tablets in the Treatment of Chronic Heart Failure

目的:研究尼可地尔联合沙库巴曲缬沙坦治疗慢性心力衰竭的疗效及其对心功能和基质金属蛋白酶2(MMP-2)、核转录因子κB(NF-κB)、基质金属蛋白酶组织抑制因子1(TIMP-1)、N末端B型利钠肽原(NT-proBNP)水平的影响。方法:选取2018年7月~2020年7月本院慢性心力衰竭患者162例作为研究对象,采用随机数字表法分为观察组和对照组,每组81例。对照组给予沙库巴曲缬沙坦治疗,观察组在对照组治疗基础上加用尼可地尔。比较两组患者的疗效,记录治疗前后两组患者左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左心室射血分数(LVEF)、血清MMP-2、NF-κB、TIMP-1、NT-proBNP、内皮素-1(ET-1)、一氧化氮(NO)改变情况。结果:治疗前,两组患者LVEDD、LVESD、LVEF、MMP-2、NF-κB、TIMP-1、NT-proBNP、ET-1、NO水平比较无统计学差异(P>0.05);治疗3个月后,两组LVEDD、LVESD、MMP-2、NF-κB、NT-proBNP和ET-1水平均低于治疗前,且观察组低于对照组(P<0.05);LVEF、TIMP-1、NO水平高于治疗前,且观察组高于对照组(P<0.05)。治疗3个月后,观察组治疗总有效率高于对照组(P<0.05)。结论:尼可地尔联合沙库巴曲缬沙坦治疗慢性心力衰竭可有效改善血管内皮功能和心肌功能、抑制心室重塑、促进心功能康复。

Objective:To study the clinical efficacy of nicorandil combined with sacubitril valsartan sodium tablets in the treatment of chronic heart failure and its effects on cardiac function and the levels of matrix metalloproteinase 2(MMP-2),nuclear transcription factor κB(NF-κB),and tissue inhibitor of matrix metalloproteinases 1(TIMP-1),N-terminal pro-B-type natriuretic peptide(NT-proBNP).Methods:A total of 162 patients with chronic heart failure in our hospital from July 2018 to July 2020 were selected as the research subjects,and divided into the observation group and the control group by random number table method,with 81 cases in each group.The control group was treated with sacubitril valsartan sodium tablets,and the observation group was treated with nicorandil on the basis of the treatment of the control group.The treatment effects of the two groups were compared,and the left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF),serum MMP-2,NF-κB,TIMP-1,NT-proBNP,endothelin-1(ET-1),and nitric oxide(NO)were recorded in the two groups before and after treatment.Results:Before treatment,there was no statistical difference in the levels of LVEDD,LVESD,LVEF,MMP-2,NF-κB,TIMP-1,NT-proBNP,ET-1 and NO between the two groups(P>0.05).The levels of LVEDD,LVESD,MMP-2,NF-κB,NT-proBNP and ET-1 in both groups after 3 months of treatment were lower than those before treatment,and the observation group was lower than the control group(P<0.05).After 3 months of treatment,the total effective rate of the observation group was significantly higher than that of the control group(P<0.05).LVEF,TIMP-1,NO levels were higher than those before treatment,the observation group was higher than the control group(P<0.05).Conclusion:Nicorandil combined with sacubitril valsartan sodium tablets in the treatment of chronic heart failure can effectively improve vascular endothelial function and myocardial function,inhibit ventricular remodeling,and promote cardiac function recovery.