沙库巴曲缬沙坦钠联合琥珀酸美托洛尔治疗心力衰竭的临床效果观察

Observation on clinical effect of sacubitril valsartan sodium tablets combined with metoprolol succinate in the treatment of heart failure

目的探析沙库巴曲缬沙坦钠+琥珀酸美托洛尔对心力衰竭(HF)治疗的效果。方法243例HF患者,随机分为对照组和观察组依次为120例、123例,分别给予琥珀酸美托洛尔治疗、给予沙库巴曲缬沙坦钠联合琥珀酸美托洛尔治疗。比较两组患者临床疗效、治疗前及治疗后血管内皮功能[降钙素基因相关肽(CGRP)、一氧化氮(NO)、内皮素(ET)]、心功能[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)、左心室缩短率(LVFS)]及氧化应激[谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)、丙二醛(MDA)]指标及不良反应发生情况。结果观察组总有效率94.31%高于对照组的81.67%(P<0.05)。治疗后,观察组LVEF为(44.72±8.42)%、LVESD为(32.80±3.96)mm、LVEDD为(43.24±4.51)mm、LVFS为(20.14±2.81)%,对照组分别为(35.87±7.16)%、(40.52±4.81)mm、(55.47±6.57)mm、(15.90±2.41)%,观察组LVEF、LVFS高于对照组,LVESD、LVEDD小于对照组(P<0.05)。治疗后,观察组CGRP为(45.18±6.72)ng/L、NO为(112.94±17.89)μmol/L、ET为(57.95±4.98)ng/L,对照组分别为(28.57±5.51)ng/L、(89.79±15.92)μmol/L、(72.05±5.91)ng/L,观察组CGRP、NO高于对照组,ET低于对照组(P<0.05)。治疗后,观察组GSH-Px为(364.46±25.94)U/L、SOD为(94.24±5.71)U/ml、MDA为(13.81±1.89)nmol/ml,对照组分别为(226.48±21.19)U/L、(81.05±4.31)U/ml、(20.94±2.34)nmol/ml,观察组GSH-Px、SOD高于对照组,MDA低于对照组(P<0.05)。两组患者不良反应发生率相近,组间对比(P>0.05)。结论HF患者通过沙库巴曲缬沙坦钠与琥珀酸美托洛尔联合治疗效果理想,值得临床推广。

Objective To investigate the effect of sacubitril-valsartan sodium+metoprolol succinate in the treatment of heart failure(HF).Methods A 243 patients with heart failure were randomly divided into a control group and an observation group,with 120 and 123 cases,respectively.They were given metoprolol succinate,and sacubactril valsartan combined with metoprolol succinate,respectively.Both groups were compared in terms of therapeutic effect,vascular endothelial function[calcitonin gene-related peptide(CGRP),nitric oxide(NO),endothelin(ET)]and cardiac function[left ventricular ejection fraction(LVEF),left ventricular endsystolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),left ventricular fractional shortening(LVFS)],and the index of oxidative stress[glutathione peroxidase(GSH-Px),superoxide dismutase(SOD),malondialdehyde(MDA)]before and after treatment,and the occurrence of adverse reactions.Results The total effective rate of the observation group was 94.31%,which was higher than that of 81.67%of the control group(P<0.05).After treatment,the observation group had LVEF of(44.72±8.42)%,LVESD of(32.80±3.96)mm,LVEDD of(43.24±4.51)mm and LVFS of(20.14±2.81)%,and those of the control group were(35.87±7.16)%,(40.52±4.81)mm,(55.47±6.57)mm and(15.90±2.41)%.LVEF and LVFS in the observation group were higher than those in the control group,and LVESD and LVEDD in the observation group were less than those in the control group(P<0.05).After treatment,CGRP,NO and ET in the observation group were(45.18±6.72)ng/L,(112.94±17.89)μmol/L and(57.95±4.98)ng/L,and those in the control group were(28.57±5.51)ng/L,(89.79±15.92)μmol/L and(72.05±5.91)ng/L.CGRP and NO in the observation group were higher than those in the control group;ET in the observation group was lower than that in the control group(P<0.05).After treatment,the observation group had GSH-Px of(364.46±25.94)U/L,SOD of(94.24±5.71)U/ml and MDA of(13.81±1.89)nmol/ml,and those of the control group were(226.48±21.19)U/L,(81.05±4.31)U/ml and(20.94±2.34)nmol/ml;GSH-Px and SOD in the observation group were higher than those in the control group;MDA in the observation group was lower than that in the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The combined treatment of Shakubatroxartan sodium and metoprolol succinate for HF patients is effective and worthy of clinical promotion.