沙库巴曲缬沙坦钠联合琥珀酸美托洛尔治疗慢性心力衰竭的临床效果及预后分析

Clinical Effect and Prognosis Analysis of Sacubitril Valsartan Sodium Combined with Metoprolol Succinate in the Treatment of Chronic Heart Failure

目的 探讨对慢性心力衰竭联合采取沙库巴曲缬沙坦钠、琥珀酸美托洛尔治疗的效果,并分析患者预后状况。方法 方便选取2021年4月—2023年10月仪征市中医院诊治的82例慢性心力衰竭患者为研究对象,采用随机数表法分为两组。对照组(41例)予琥珀酸美托洛尔治疗,观察组(41例)在对照组治疗基础上结合沙库巴曲缬沙坦钠治疗,比较两组临床效果、心功能、血清学指标、运动耐力、生活质量以及不良反应发生率。结果 与对照组相比,观察组疗效率更高(95.12%vs 78.05%),差异有统计学意义(χ^(2)=5.145,P<0.05)。治疗后患者左心室收缩末内径(Left Ventricular End Systolic Diameter, LVESD)、左心室舒张末内径(Left Ventricular End Diastolic Diameter, LVEDD)水平较治疗前降低,左心室射血分数(Left Ventricular Ejection Fraction,LVEF)水平较治疗前升高,且观察组LVESD、LVEDD水平较对照组更低、LVEF水平更高,差异有统计学意义(P均<0.05)。治疗后患者N末端B型利钠肽前体(N-terminal pro-B type natriuretic peptide, NT-proBNP)、明尼苏达生活量表(Minnesota Life Scale, MLHFQ)评分较治疗前降低,6 min步行距离较治疗前延长;且与对照组相比,观察组NT-proBNP水平、MLHFQ评分均更低、6 min步行距离更长,差异有统计学意义(P均<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 琥珀酸美托洛尔联合沙库巴曲缬沙坦钠治疗慢性心力衰竭,可使患者取得较为理想的效果,且对患者的心功能、耐受能力、生活质量的改善更为显著。

Objective To explore the effect of treating chronic heart failure with sacubitril valsartan sodium and metoprolol succinate,and to analyze the prognosis of patients.Methods 82 patients with chronic heart failure treated at Yizheng Traditional Chinese Medicine Hospital from April 2021 to October 2023 were conveniently selected as the study objects and randomly divided into two groups using a random number table method.The control group(41 cases)was treated with metoprolol succinate,while the observation group(41 cases)was treated with sacubitril valsartan sodium in addition to the control group.The clinical outcome,cardiac function,serologic indexes,exercise tolerance,quality of life,and adverse reactions were compared between the two groups.Results Compared with the control group,the observation group had a higher efficacy rate(95.12%vs 78.05%),and the difference was statistically significant(χ^(2)=5.145,P<0.05).After treatment,the levels of left ventricular end systolic diameter(LVESD)and left ventricular end diastolic diameter(LVEDD)in patients decreased compared to before treatment,while the levels of left ventricular ejection fraction(LVEF)increased compared to before treatment.The LVESD and LVEDD levels in the observation group were lower than those in the control group,and the LVEF levels were higher than those in the control group,and the differences were statistically significant(all P<0.05).After treatment,the N-terminal pro-B type natriuretic peptide(NT-proBNP)and Minnesota Life Scale(MLHFQ)scores of patients decreased compared to before treatment,and the 6-minute walking distance was extended compared to before treatment. Compared with the control group, the ob servation group had lower NT-proBNP levels and MLHFQ scores, and longer 6-minute walking distance, and the dif ferences were statistically significant (all P<0.05). There was no statistically significant difference in the rate of ad verse reactions between the two groups (P>0.05). Conclusion The combination of metoprolol succinate and sacubitril valsartan sodium in the treatment of chronic heart failure can achieve more satisfactory results in patients, and signifi cantly improve their cardiac function, tolerance, and quality of life.