沙库巴曲缬沙坦钠联合曲美他嗪治疗慢性心力衰竭患者的效果

Effects of Sacubitril and valsartan sodium combined with Trimetazidine on patients with chronic heart failure

目的:观察沙库巴曲缬沙坦钠联合曲美他嗪治疗慢性心力衰竭(CHF)患者的效果。方法:选取2019年5月至2021年7月该院收治的125例CHF患者进行前瞻性研究,按照随机数字表法分为对照组62例和观察组63例。两组均实施常规抗心力衰竭治疗,在此基础上,对照组采用依那普利联合曲美他嗪治疗,观察组采用沙库巴曲缬沙坦钠联合曲美他嗪治疗。比较两组临床疗效、治疗前后心功能指标[左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、心率(HR)、6 min步行试验距离(6MWT)]、血清心衰标志物[心肌肌钙蛋白I(cTnI)、N末端B型脑钠肽前体(NT-proBNP)]水平,以及不良反应发生率。结果:观察组治疗总有效率为90.48%(57/63),高于对照组的77.42%(48/62),差异有统计学意义(P<0.05);治疗3个月后,观察组LVEDD、HR、cTnI、NT-proBNP水平均低于对照组,LVEF、6MWT水平均高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:沙库巴曲缬沙坦钠联合曲美他嗪治疗CHF患者,可提高临床疗效,改善心功能,降低cTnI、NT-proBNP水平,效果优于依那普利联合曲美他嗪治疗,安全性与之相当。

Objective:To explore effects of Sacubitril and valsartan sodium combined with Trimetazidine on patients with chronic heart failure(CHF).Methods:125 patients with CHF who were admitted to our hospital from May 2019 to July 2021 were selected for the prospective study.According to the random number table method,they were divided into control group(62 cases)and observation group(63 cases).Both groups received conventional anti-heart failure treatment.On this basis,the control group was treated with Enalapril combined with Trimetazidine,while the observation group was treated with Sacubitril and valsartan sodium combined with Trimetazidine.The clinical efficacy,the cardiac function index levels[left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),heart rate(HR),6-min walking test(6MWT)],the serum heart failure marker levels[cardiac troponin I(cTnI),N-terminal pro-B-type natriuretic peptide(NT-proBNP)],and the incidence of adverse reactions were compared between the two groups before and after the treatment.Results:The total effective rate of treatment in the observation group was 90.48%(57/63),which was higher than the control group of 77.42%(48/62),and the difference was statistically significant(P<0.05).After 3 months of treatment,the levels of LVEDD,HR,cTnI and NT-proBNP in the observation group were lower than those in the control group;the levels of LVEF and 6MWT were higher than those in the control group;and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Sacubitril valsartan sodium combined with Trimetazidine in the treatment of THE CHF patients can improve clinical efficacy,improve THE cardiac function,and reduce the levels of cTnI and NT-proBNP.Further,its effects are better than Enalapril combined with Trimetazidine;however,the safety is comparable.