沙库巴曲缬沙坦联合比索洛尔治疗慢性心力衰竭效果观察及对患者NT-pro BNP水平的影响

Efficacy of sacubitril and valsartan combined with bisoprolol in the treatment of chronic heart failure and its effect on N-terminal pro-brain natriuretic peptide level

目的探讨沙库巴曲缬沙坦联合比索洛尔治疗慢性心力衰竭(CHF)的临床疗效及其对患者氨基末端脑钠肽原(NT-pro BNP)水平的影响。方法回顾性分析济南市第二人民医院2020年1月至2022年4月收治的CHF患者89例的临床资料,依据治疗方法不同将患者分为A组48例、B组41例。A组采用沙库巴曲缬沙坦联合比索洛尔治疗,B组采用沙库巴曲缬沙坦联合美托洛尔治疗,均治疗3个月。比较两组临床疗效及治疗前后心功能、NT-pro BNP水平的差异,观察两组不良反应发生情况。结果A组总有效率为95.8%(46/48),高于B组的82.9%(34/41)(χ^(2)=4.05,P<0.05)。治疗后,两组左室射血分数均显著上升,且A组高于B组(t=2.19,P<0.05)。治疗后,A组NT-pro BNP为(416.51±30.56)ng/L,明显低于B组的(450.20±35.79)ng/L(t=4.79,P<0.001)。两组不良反应发生率差异无统计学意义(P>0.05)。结论沙库巴曲缬沙坦联合比索洛尔治疗CHF的疗效优于沙库巴曲缬沙坦联合美托洛尔,可显著降低NT-pro BNP水平,临床可以根据患者实际需求选择相应药物进行治疗。

Objective To investigate the clinical efficacy of sacubitril and valsartan combined with bisoprolol in the treatment of chronic heart failure and its effect on N-terminal pro-brain natriuretic peptide(NT-pro BNP)level.Methods The clinical data of 89 patients with chronic heart failure who received treatment in Jinan 2nd People's Hospital from January 2020 to April 2022 were retrospectively analyzed.These patients were divided into Group A(n=48)and Group B(n=41)according to different treatment methods.Group A was treated with sacubitril and valsartan combined with bisoprolol.Group B was treated with sacubitril and valsartan combined with metoprolol.All patients were treated for 3 months.Clinical efficacy as well as heart function and NT-pro BNP level pre-and post-treatment were compared between the two groups.The incidence of adverse reactions was calculated in each group.Results Total response rate in group A was significantly higher than that in group B[95.83%(46/48)vs.82.93%(34/41),χ^(2)=4.05,P<0.05].After treatment,the left ventricular ejection fraction in both groups increased significantly and the left ventricular ejection fraction in group A was significantly higher than that in group B(t=2.19,P<0.05).After treatment,NT-pro BNP level in group A was(416.51±30.56)ng/L,which was significantly lower than(450.20±35.79)ng/L in group B(t=4.79,P<0.001).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The efficacy of sacubitril and valsartan combined with bisoprolol in the treatment of chronic heart failure is superior to that of sacubitril and valsartan combined with metoprolol.The former can greatly decrease NT-pro BNP level.Corresponding drugs can be selected for the treatment of chronic heart failure according to the actual needs of patients.