稳心颗粒联合沙库巴曲缬沙坦治疗老年慢性心力衰竭的疗效

Effect of Wenxin granule combined with sakubatrel valsartan in elderly patients with chronic heart failure

目的探讨稳心颗粒联合沙库巴曲缬沙坦治疗老年慢性心力衰竭(CHF)的临床疗效以及其对患者血液流变学和血清半乳糖凝集素-3(Gal-3)、N末端B型利钠肽原(NT-proBNP)、高迁移率族蛋白1(HMGB1)水平的影响。方法选择2020年1月至2021年12月收治的108例老年CHF患者作为研究对象,按随机数字表法平均分为两组。其中观察组采用稳心颗粒联合沙库巴曲缬沙坦治疗,对照组单用沙库巴曲缬沙坦治疗,疗程均为12周。比较两组临床疗效。治疗前后检测两组受测对象心功能相关指标[心率(HR)、左室射血分数(LVEF)、每搏输出量(SV)、心输出量(CO)],血液流变学指标[全血高切黏度(HBV)、全血低切黏度(LBV)、血浆黏度(PV)、纤维蛋白原(FIB)]以及血清Gal-3、NT-proBNP、HMGB1水平。统计两组不良反应发生情况。结果观察组总有效率为92.59%(50/54),与对照组[77.78%(42/54)]相比显著升高(P<0.05)。治疗后,两组HR比治疗前均显著降低(P<0.05),LVEF、SV、CO比治疗前均显著升高(P<0.05);且治疗后,观察组HR显著低于对照组(P<0.05),LVEF、SV、CO均显著大于对照组(P<0.05)。两组治疗后HBV、LBV、PV和FIB比治疗前均显著下降(P<0.05);治疗后,观察组HBV、LBV、PV和FIB均显著低于对照组(P<0.05)。两组治疗后血清Gal-3、NT-proBNP和HMGB1浓度比治疗前均显著降低(P<0.05);但治疗后,观察组血清Gal-3、NT-proBNP和HMGB1水平均显著低于对照组(P<0.05)。观察组不良反应发生率[5.56%(3/54)]与对照组[7.41%(4/54)]比较,差异无统计学意义(P>0.05)。结论稳心颗粒联合沙库巴曲缬沙坦治疗老年CHF能安全有效地下调患者血清Gal-3、NT-proBNP、HMGB1的表达水平,纠正血液流变学异常,改善心功能,提高临床疗效。

Objective To investigate the clinical efficacy of Wenxin granules combined with sakubatrel valsartan on the treatment of elderly chronic heart failure(CHF)and its effects on hemorheology,serum levels of galactoagglutinin-3(GAL-3),N-terminal B-type natriuretic peptide progenogen(NT-probNP)and high mobility group protein 1(HMGB1).Methods A total of 108 elderly patients with CHFl from January 2020 to December 2021 were selected,and divided into two groups according to random number table method.The observation group was treated with Wenxin granule combined with sakobactral valsartan,and the control group was treated with sakobactral valsartan alone,with a course of 12 weeks.The clinical efficacies of the two groups was compared.Cardiac function related indicators,including heart rate(HR),left ventricular ejection fraction(LVEF),stroke output(SV),and cardiac output(CO),were detected before and after treatment.Hemorheology indexes,including whole blood high shear viscosity(HBV),whole blood low shear viscosity(LBV),plasma viscosity(PV),fibrinogen(FIB),and serum levels of Gal-3,NT-probNP and HMGB1,were recorded.The adverse reactions of the two groups were counted.Results The total effective rate of observation group was 92.59%(50/54),significantly higher than that of control group(77.78%,42/54)(P<0.05).After treatment,HR in the 2 groups were significantly reduced(P<0.05),while LVEF,SV and CO were significantly increased(P<0.05).After treatment,HR in observation group was significantly lower than control group(P<0.05),and LVEF,SV,and CO were significantly higher than control group(P<0.05).After treatment,HBV,LBV,PV and FIB in the 2 groups were significantly reduced(P<0.05).After treatment,HBV,LBV,PV and FIB in observation group were significantly lower than those in control group(P<0.05).After treatment,the concentrations of serum Gal-3,NT-probNP and HMGB1 in the 2 groups were significantly reduced compared with those before treatment(P<0.05).However,after treatment,the levels of serum Gal-3,NT-probNP and HMGB1 in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the rate of adverse reactions between the observation group(5.56%,3/54)and the control group(7.41%,4/54)(P>0.05).Conclusion Wenxin granule combined with sakubatrel valsartan in the treatment of elderly CHF can safely and effectively down-regulate the expression levels of serum Gal-3,NT-probNP and HMGB1,correct hemorheology abnormalities,improve cardiac function and improve clinical efficacy.