探讨沙库巴曲缬沙坦联合曲美他嗪治疗慢性充血性心力衰竭的临床疗效及安全性

Clinical efficacy and safety of sacubactril valsartan combined with trimetazidine in the treatment of chronic congestive heart failure

目的探讨沙库巴曲缬沙坦、曲美他嗪联用治疗慢性充血性心力衰竭的疗效及安全性。方法以76例慢性充血性心力衰竭患者为研究对象,按抽签法分为甲组及乙组,每组38例。甲组给予依那普利+曲美他嗪治疗,乙组给予沙库巴曲缬沙坦+曲美他嗪治疗。比较两组患者的治疗效果,心功能指标[左心室射血分数(LVEF)、N末端脑钠肽前体(NT-proBNP)水平及6 min步行试验距离(6MWD)、左心室舒张末期内径(LVEDD)],不良反应发生率及住院时间。结果乙组治疗总有效率97.37%高于甲组的81.58%,差异具有统计学意义(χ^(2)=5.0294,P=0.0249<0.05)。两组治疗前的LVEF、NT-proBNP、6MWD、LVEDD比较,差异无统计学意义(P>0.05);乙组治疗后的LVEF(51.27±5.65)%高于甲组的(47.84±5.25)%、NT-proBNP(867.87±66.56)pg/ml低于甲组的(911.26±76.98)pg/ml、6MWD(366.73±55.68)m长于甲组的(314.54±65.65)m、LVEDD(53.12±5.23)mm小于甲组的(56.76±5.78)mm,差异具有统计学意义(P<0.05)。乙组不良反应发生率低于甲组,但差异无统计学意义(P>0.05)。乙组住院时间(8.34±2.17)d短于甲组的(12.90±2.89)d,差异具有统计学意义(P<0.05)。结论沙库巴曲缬沙坦联用曲美他嗪治疗慢性充血性心力衰竭疗效确切,同时对心脏功能有明显的改善,是一种具有较好临床应用价值的治疗方案。

Objective To explore the efficacy and safety of sacubactril valsartan combined with trimetazidine in the treatment of chronic congestive heart failure.Methods 76 patients with chronic congestive heart failure were selected as study subjects,and were divided into group A and group B according to the lottery method,with 38 cases in each group.Group A was treated with enalapril+trimetazidine,and group B was treated with sacubactril valsartan+trimetazidine.Comparison was made on treatment effect,cardiac function indicators[left ventricular ejection fraction(LVEF),N-terminal-pro brain natriuretic peptide(NT-proBNP)levels,6-min walking distance(6MWD),and left ventricular end diastolic diameter(LVEDD)],incidence of adverse reactions,and hospitalization time between the two groups.Results The total effective rate of group B was 97.37%,which was higher than 81.58%of group A,and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in LVEF,NT-proBNP,6MWD and LVEDD between the two groups(P>0.05).After treatment,group B had higher LVEF of(51.27±5.65)%than(47.84±5.25)%in group A,lower NT-proBNP of(867.87±66.56)pg/ml than(911.26±76.98)pg/ml in group A,longer 6MWD of(366.73±55.68)m than(314.54±65.65)m in group A,and smaller LVEDD of(53.12±5.23)mm than(56.76±5.78)mm in group A.The difference was statistically significant(P<0.05).The incidence of adverse reactions in group B was lower than that in group A,but difference was not statistically significant(P>0.05).The hospitalization time of(8.34±2.17)d in group B was shorter than(12.90±2.89)d in group A,and the difference was statistically significant(P<0.05).Conclusion The combination of sacubactril valsartan and trimetazidine in the treatment of chronic congestive heart failure is effective and has obvious improvement in cardiac function,which is a treatment plan with good clinical application value.