沙库巴曲缬沙坦联合美托洛尔治疗慢性心力衰竭的疗效观察

Efficacy observation of sacubitril-valsartan combined with metoprolol in the treatment of chronic heart failure

目的观察沙库巴曲缬沙坦联合美托洛尔治疗慢性心力衰竭的临床疗效。方法60例慢性心力衰竭患者作为研究对象,随机分为观察组与对照组,各30例。对照组采用美托洛尔治疗,观察组采用沙库巴曲缬沙坦联合美托洛尔治疗。对比两组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)、左心室收缩末期内径(LVESD)、心脏每搏输出量(SV)]、炎性因子指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)]、血清氨基末端脑钠肽前体(NT-proBNP)、不良反应发生情况及治疗效果。结果治疗后,观察组LVEDD(44.12±2.32)mm、LVESD(53.02±4.32)mm小于对照组的(48.56±2.26)、(62.24±4.42)mm,LVEF(52.68±3.26)%、SV(57.43±3.06)ml高于对照组的(41.48±3.03)%、(50.86±3.45)ml,差异均有统计学意义(P<0.05)。治疗后,观察组TNF-α(105.06±11.68)pg/ml、IL-6(121.47±16.25)pg/ml、CRP(38.33±4.96)mg/L低于对照组的(135.26±13.45)pg/ml、(164.23±19.63)pg/ml、(66.05±5.85)mg/L,差异均有统计学意义(P<0.05)。观察组不良反应发生率6.67%低于对照组的26.67%,差异有统计学意义(P<0.05)。治疗后,观察组NT-proBNP(405.36±21.42)ng/L低于对照组的(463.25±22.36)ng/L,差异有统计学意义(P<0.05)。观察组临床治疗总有效率96.67%高于对照组的80.00%,差异有统计学意义(P<0.05)。结论在慢性心力衰竭疾病治疗中使用沙库巴曲缬沙坦联合美托洛尔治疗,有助于提升患者的心功能,改善炎性因子水平及临床症状,治疗效果良好。

Objective To observe the clinical efficacy of sacubitril-valsartan combined with metoprolol in the treatment of chronic heart failure.Methods A total of 60 patients with chronic heart failure were studied and randomly divided into observation group and control group,with 30 cases in each group.The control group was treated with metoprolol,and the observation group was treated with sakubatril-valsartan combined with metoprolol.Both groups were compared in terms of cardiac function indexes[left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),stroke volume(SV)],inflammatory factor indexes[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)],N-terminal pro-brain natriuretic peptide(NT-proBNP)before and after treatment,the occurrence of adverse reactions,and therapeutic effect.Results After treatment,the LVEDD(44.12±2.32)mm and LVESD(53.02±4.32)mm in the observation group were less than(48.56±2.26)and(62.24±4.42)mm in the control group;the LVEF(52.68±3.26)%and SV(57.43±3.06)ml in the observation group were higher than(41.48±3.03)%and(50.86±3.45)ml in the control group;the differences were all statistically significant(P<0.05).After treatment,the TNF-α(105.06±11.68)pg/ml,IL-6(121.47±16.25)pg/ml,and CRP(38.33±4.96)mg/L in the observation group were lower than(135.26±13.45)pg/ml,(164.23±19.63)pg/ml,and(66.05±5.85)mg/L in the control group,and the differences were all statistically significant(P<0.05).The incidence of adverse reactions 6.67%in the observation group was lower than 26.67%in the control group,and the difference was statistically significant(P<0.05).After treatment,the NT-proBNP(405.36±21.42)ng/L in the observation group was lower than(463.25±22.36)ng/L in the control group,and the difference was statistically significant(P<0.05).The total effective rate of clinical treatment of the observation group was 96.67%,which was higher than 80.00%of the control group,and the difference was statistically significant(P<0.05).Conclusion The use of sacubitril-valsartan combined with metoprolol in the treatment of chronic heart failure can help improve the cardiac function of patients,improve the level of inflammatory factors and clinical symptoms,and the therapeutic effect is good.