沙库巴曲缬沙坦联合美托洛尔治疗慢性心力衰竭患者的效果

Effects of Sacubitril/Valsartan combined with Metoprolol in treatment of patients with 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(CHF)患者的效果。方法:选取2021年3月至2022年12月该院收治的80例CHF患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各40例。两组均予以常规治疗,在此基础上,对照组采用美托洛尔治疗,观察组在对照组基础上联合沙库巴曲缬沙坦治疗,两组均持续治疗3个月。比较两组临床疗效,治疗前后心功能指标[左心室射血分数(LVEF)、左心室质量指数(LVMI)]水平、血清学指标[N-末端脑钠肽前体(NT-proBNP)、心肌肌钙蛋白I(cTnI)]水平、炎性因子[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]水平,以及不良反应发生率。结果:观察组治疗总有效率为87.50%(35/40),高于对照组的62.50%(25/40),差异有统计学意义(P<0.05);治疗后,观察组LVMI水平低于对照组,LVEF水平高于对照组,差异有统计学意义(P<0.05);治疗后,观察组cTnI、NT-proBNP水平均低于对照组,差异有统计学意义(P<0.05);治疗后,观察组TNF-α、IL-6、hs-CRP水平均低于对照组,差异有统计学意义(P<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:沙库巴曲缬沙坦联合美托洛尔治疗CHF患者可提高治疗总有效率,改善心功能指标水平,降低血清学指标和炎性因子水平,效果优于单纯美托洛尔治疗。

Objective:To observe effects of Sacubitril/Valsartan combined with Metoprolol in treatment of patients with chronic heart failure(CHF).Methods:A prospective study was conducted on 80 patients with CHF admitted to the hospital from March 2021 to December 2022.According to the random number table method,they were divided into control group and observation group,40 cases in each group.Both groups were given routine treatment.On this basis,the control group was treated with Metoprolol,while the observation group was treated with Sacubitril/Valsartan on the basis of that of the control group.Both groups were treated for 3 months.The clinical efficacy,the cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular mass index(LVMI)]levels,the serological indexes[N-terminal pro-brain natriuretic peptide(NTproBNP),cardiac troponin I(cTnI)]levels,the inflammatory indexes[high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)]levels,and the incidence of adverse reactions were compared between the two groups before and after the treatment.Results:The total effective rate of the observation group was 87.50%(35/40),which was higher than 62.50%(25/40)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the LVMI level of the observation group was lower than that of the control group,the LVEF level was higher than that of the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of cTnI and NT-proBNP in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of TNF-α,IL-6 and hs-CRP in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Sacubitril/Valsartan combined with Metoprolol in the treatment of the CHF patients can improve the total effective rates,improve the levels of cardiac function indicators,and reduce the levels of serological indexes and inflammatory indexes.Moreover,it is superior to single Metoprolol treatment.