依那普利、螺内酯联合比索洛尔治疗风湿性心脏瓣膜病合并慢性心力衰竭的临床疗效

The Efficacy of the Combination of Enalapril,Spironolactone and Bisoprolol in the Treatment of Rheumatic Heart Valvular Disease with Chronic Heart Failure

目的:观察依那普利、螺内酯联合比索洛尔治疗方案治疗风湿性心脏瓣膜病(RHD)合并慢性心力衰竭(CHF)患者的效果.方法:选取2017年3月至2022年3月于本院治疗的127例RHD合并CHF患者作为研究对象.根据治疗方案的不同将其分为研究组(n=67,依那普利、螺内酯联合比索洛尔治疗)和对照组(n=60,依那普利、螺内酯治疗).比较两组临床疗效、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)、N末端脑钠肽前体(NT-proBNP)水平以及不良反应.结果:研究组临床总有效率为94.03%(63/67),高于对照组81.67%(49/60),差异有统计学意义(P<0.05);治疗后研究组LVEDD、LVESD下降程度以及LVEF上升程度更为明显,差异有统计学意义(P<0.05);治疗后,研究组NT-proBNP水平低于对照组,差异有统计学意义(P<0.05);两组不良反应比较,差异无统计学意义(P>0.05).结论:三种药物联合方案可提高对RHD合并CHF的治疗效果,显著改善患者的左心功能,且安全性好.

Objective:To observe the efficacy of enalapril,spironolactone and bisoprolol treatment in patients with rheumatic heart valvular disease(RHD)and chronic heart failure(CHF).Methods:A total of 127 patients with rheumatic valvular heart disease complicated with chronic heart failure who were treated in our hospital from March 2017 to March 2022 were selected in this study.And they were divided into study group(n=67,enalapril,spironolactone combined with bisoprolol)and control group(n=60,enalapril,spironolactone treatment)according to different treatment plans.The clinical efficacy,left ventricular end diastolic dimension(LVEDD),left ventricular end systolic diameter(LVESD),left ventricular ejection fractions(LVEF),N-terminal pro-brain natriuretic peptide(NT-proBNP)and the incidence of adverse reactions were compared between two groups.Results:The total clinical effective rate of study group was 94.03%(63/67),which was higher than 81.67%(49/60)of control group,with a statistically significant difference(P<0.05).After treatment,study group showed more significant decrease in LVEDD,LVESD,and an increase in LVEF(P<0.05).After treatment,the NT-proBNP level in study group was lower than that in control group(P<0.05).There was no difference in the incidence of adverse reactions between two groups(P>0.05).Conclusions:The combination of three drugs can improve clinical efficacy RHD combined with CHF,significantly improve left ventricular function.