基于心功能及IGFBP7、sST2、CGRP、ET分析沙库巴曲缬沙坦在治疗冠心病合并慢性心力衰竭中的应用效果

Analysis of the application effect of sacubitril⁃valsartan in the treatment of coronary heart disease combined with chronic heart failure based on cardiac function and IGFBP7,sST2,CGRP,and ET

目的 分析冠心病(CHD)合并慢性心力衰竭(CHF)患者应用沙库巴曲缬沙坦治疗的效果。方法 选择2020年1月至2023年1月邯郸市第四医院收治的86例CHD合并CHF患者,以随机数字表法将其分为对照组和试验组各43例。两组CHD治疗均应用硝酸酯类、他汀类及抗血小板药物,对照组CHF治疗应用坎地沙坦酯片、醛固酮受体拮抗剂及β受体阻滞剂,试验组治疗则将对照组中的坎地沙坦酯片替换为沙库巴曲缬沙坦钠片。比较两组疗效、不良反应、心功能指标[左室短轴缩短率(LVFS)、左室射血分数(LVEF)、6min步行距离(6 MWD)]、心室重构指标[Ⅲ型胶原前肽(PⅢP)、层粘蛋白(LN)、基质金属蛋白酶-9(MMP-9)]、心肌损伤和血管内皮功能相关指标[胰岛素样生长因子结合蛋白7(IGFBP7)、可溶性生长刺激表达基因2(sST2)、降钙素基因相关肽(CGRP)、内皮素(ET)]。结果与对照组比,试验组治疗3个月后的总有效率更高,差异有统计学意义(P<0.05)。两组治疗3个月后的LVFS、LVEF、6 MWD、IGFBP7、CGRP与治疗前比升高,且试验组与对照组比更高,差异有统计学意义(P<0.05);PⅢP、LN、MMP-9、sST2、ET降低,试验组与对照组比更低,差异有统计学意义(P<0.05)。两组不良反应总发生率对比差异无统计学意义(P>0.05)。结论 沙库巴曲缬沙坦可有效调节CHD合并CHF患者IGFBP7、sST2、CGRP、ET,改善血管内皮功能、心肌损伤、心室重构及心功能,进而可提高疗效,且具有良好的安全性。

Objective To analyze the efficacy of treatment with sacubitril valsartan in patients with coronary heart disease(CHD)combined with chronic heart failure(CHF).Methods From January 2020 to January 2023,86 patients with CHD complicated by CHF were selected at our hospital.They were ran-domly divided into two groups:the control group and the experimental group,each consisting of 43 patients.Both groups received treatment for CHD with nitrates,statins and antiplatelet agents.The control group was treated for CHF with candesartan ester tablets,aldosterone receptor antagonists and beta-blockers,while the experimental group replaced candesartan ester tablets with sakubatrizol valdecoxib sodium tablets.The effica-cy,adverse effects,cardiac function indexes[including left ventricular short-axis shortening(LVFS),left ventricular ejection fraction(LVEF),and 6-minute walking distance(6 MWD)],ventricular remodeling in-dexes[such as pre-collagenⅢpeptide(PⅢP),laminin(LN),and matrix metalloproteinase-9(MMP-9)],as well as indexes related to myocardial injury and vascular endothelial function[such as insulin-like growth factor-binding protein 7(IGFBP7),soluble growth-stimulated expression gene 2(sST2),calcitonin gene-re-lated peptide(CGRP),and endothelin(ET)],were compared between the two groups.Results The total ef-fective rate was higher in the test group after 3 months of treatment compared with the control group(P<0.05).LVFS,LVEF,6 MWD,and IGFBP7,CGRP were elevated after 3 months of treatment in both groups compared with pre-treatment and were higher in the experimental group compared with the control group.PⅢP,LN,MMP-9,sST2,and ET were lowered,and were lower in the experimental group compared with the con-trol group(P<0.05).There was no difference in the comparison of the total incidence of adverse reactions be-tween the two groups(P>0.05).Conclusion Sacubitril valsartan is used to treat CHD in combination with CHF.It effectively regulates patientsIGFBP7,sST2,CGRP,and ET levels,improving vascular endothelial function,myocardial injury,ventricular remodeling and cardiac function.This,in turn,enhances the efficacy of the treatment and has a good safety profile.