沙库巴曲缬沙坦联合比索洛尔治疗慢性心力衰竭患者的效果

Effects of Sacubitril/Valsartan combined with Bisoprolol in treatment of patients with chronic heart failure

目的:观察沙库巴曲缬沙坦联合比索洛尔治疗慢性心力衰竭(CHF)患者的效果。方法:选取2019年8月至2021年10月该院收治的105例CHF患者进行前瞻性研究,按照随机数字表法将其分为对照组52例、观察组53例。两组均予以常规治疗,在此基础上,对照组口服比索洛尔治疗,观察组在对照组基础上联合沙库巴曲缬沙坦治疗,两组均连续治疗3个月。比较两组临床疗效、治疗前后心功能指标[左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、心排血量(CO)]水平、炎性因子[白细胞介素-18(IL-18)、超敏C反应蛋白(hs-CRP)]水平、心肌能量代谢指标[血清游离脂肪酸(FFA)、左心室收缩末圆周室壁应力(cESS)、心肌能量消耗(MEE)]水平,以及不良反应发生率。结果:观察组治疗总有效率为92.45%(49/53),高于对照组的76.92%(40/52),差异有统计学意义(P<0.05);治疗后,观察组LVEF、CO水平均高于对照组,LVESD、LVEDD、IL-18、hs-CRP、FFA、cESS、MEE水平均低于对照组,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:沙库巴曲缬沙坦联合比索洛尔治疗CHF患者可提高治疗总有效率,改善心功能指标,以及降低心肌能量代谢指标和炎性因子水平,效果优于单纯比索洛尔治疗。

Objective:To observe effects of Sacubitril/Valsartan combined with Bisoprolol in treatment of patients with chronic heart failure(CHF).Methods:A prospective study was conducted on 105 patients with CHF admitted to the hospital from August 2019 to October 2021.They were divided into control group(52 cases)and observation group(53 cases)according to the random number table method.Both groups were given routine treatment.On this basis,the control group was treated with Bisoprolol orally,while the observation group was treated with Sacubitril/Valsartan on the basis of that of the control group.Both groups were treated for 3 months.The clinical efficacy,the cardiac function index levels[left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),cardiac output(CO)],the inflammatory factor levels[interleukin-18(IL-18),high-sensitivity C-reactive protein(hs-CRP)],the myocardial energy metabolism indexes levels[serum free fatty acid(FFA),left ventricular end-systolic circumferential wall stress(cESS),myocardial energy expenditure(MEE)],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 92.45%(49/53),which was higher than 76.92%(40/52)in the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of LVEF and CO in the observation group were higher than those in the control group,the levels of LVESD,LVEDD,IL-18,hs-CRP,FFA,cESS and MEE were lower 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 combined with Bisoprolol in the treatment of the CHF patients can improve the total effective rate of treatment,improve the cardiac function index levels,and reduce the myocardial energy metabolism index levels and the inflammatory factor levels.Moreover,it is superior to single Bisoprolol treatment.