沙库巴曲缬沙坦联合美托洛尔治疗慢性心力衰竭的临床效果

Clinical effect of sacubitril valsartan combined with metoprolol in the treatment of chronic heart failure

目的观察沙库巴曲缬沙坦联合美托洛尔治疗慢性心力衰竭(以下简称为心衰)的临床效果。方法选取2021年7月—2023年3月九江市第一人民医院收治的68例慢性心衰患者,根据随机数字表法分为A组和B组,各34例。A组予美托洛尔,B组在A组基础上联合沙库巴曲缬沙坦,2组均需持续用药12周。比较2组临床疗效,用药前及用药12周后心功能指标[左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)、左心室舒张末期内径(LVEDD)]、24 h尿量及实验室指标[血肌酐、血浆B型脑钠肽(BNP)及血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)],不良反应。结果B组总有效率高于A组(97.06%vs.76.47%,χ^(2)=4.610,P=0.032)。用药12周后,2组LVEF高于用药前,LVFS大于用药前,LVEDD小于用药前,且B组优于A组(P<0.01);2组24 h尿量多于用药前,血肌酐、血浆BNP及血清CRP、TNF-α、IL-6水平低于用药前,且B组优于A组(P<0.05或P<0.01)。B组不良反应总发生率为11.76%,与A组的5.88%比较,差异无统计学意义(χ^(2)=0.183,P=0.669)。结论慢性心衰患者采用沙库巴曲缬沙坦联合美托洛尔治疗能增强疗效,可有效改善患者心功能,减轻炎性反应,且联合用药不会增加不良反应,用药较安全。

Objective To investigate the clinical effect of sacubitril valsartan combined with metoprolol in the treatment of chronic heart failure.Methods A total of 68 patients with chronic heart failure admitted to Jiu Jiang NO.1 People′s Hospital from July 2021 to March 2023 were included in the study,and they were divided into the group A and group B by random number table method,34 cases in each group.The group A was treated with metoprolol,and the group B was combined with sacubitril valsartan on the basis of group A,both groups were medicated for 12 weeks.Clinical effect,cardiac function indexes(LVEF,LVFS,LVEDD),24 h urine volume and laboratory indexes(SCr,plasma BNP and serum CRP,TNF-α,IL-6)before and after 12 weeks of medication,incidence of adverse reactions were compared between the two groups.Results The total effective rate of the group B was higher than that of the group A(97.06%vs.76.47%,χ2=4.610,P=0.032).Compared with those before medication,LVEF after 12 weeks of medication of the two groups was higher,LVFS was larger,LVEDD was less,and those in the group B were better than group A(P<0.01);24 h urine volume after 12 weeks of medication of the two groups was more,SCr,plasma BNP,and serum CRP,TNF-α,IL-6 levels were lower,and those of the group B were better than group A(P<0.05 or P<0.01).Incidence of adverse reactions of the group B was 11.76%,and there was no significant difference compared with 5.88%of group A(χ2=0.183,P=0.669).Conclusion For patients with chronic heart failure,the combination of sacubitril valsartan and metoprolol can significantly improve the therapeutic effect,improve the cardiac function,reduce the inflammation,and without increasing adverse reactions,with higher safaty.