低剂量阿司匹林联合沙库巴曲缬沙坦治疗慢性心力衰竭的效果观察

Observation of therapeutic effect of low-dose aspirin combined with sacubitril/valsartan on chronic heart failure

目的分析低剂量阿司匹林联合沙库巴曲缬沙坦治疗慢性心力衰竭的临床疗效。方法随机对照研究。抽取2021年1月至2022年12月平煤神马医疗集团总医院收治的慢性心力衰竭患者90例,按随机数字表法分为单一组和联合组,每组45例。单一组予以低剂量阿司匹林治疗,联合组在单一组基础上联合沙库巴曲缬沙坦治疗。对比两组临床疗效、心功能[左心室射血分数(LVEF)、左心室舒张末期容积(LVEDV)]水平、明尼苏达心力衰竭生活质量调查表(MLHFQ)评分、凝血功能[凝血酶原时间(PT)、D-二聚体(D-D)、活化部分凝血活酶时间(APTT)]水平及不良反应发生率。结果联合组总有效率(93.33%,42/45)高于单一组(77.78%,35/45),P<0.05。治疗后,联合组LVEDV水平均低于单一组,LVEF水平高于单一组(P<0.05);治疗后,联合组MLHFQ评分低于单一组(P<0.05);治疗后,联合组PT、APTT长于单一组,D-D水平低于单一组(P<0.05)。两组不良反应发生率比较差异未见统计学意义(P>0.05)。结论对慢性心力衰竭患者采用低剂量阿司匹林联合沙库巴曲缬沙坦治疗,可提高临床治疗效果,改善凝血功能、心功能,提高其生活质量。

Objective To analyze the effect of low-dose aspirin combined with sacubitril/valsartan in the treatment of chronic heart failure.Methods A total of 90 patients with chronic heart failure treated in General Hospital of Pingmei Shenma Group from January 2021 to December 2022 were selected for the randomized controlled study.And they were divided into the single group and the combination group according to random number table method,with 45 cases in each group.The single group was treated with low-dose aspirin,and the combination group was treated with sacubitril/valsartan based on the treatment of the single group.The clinical efficacy,cardiac function assessed by left ventricular ejection fraction(LVEF)and left ventricular end-diastolic volume(LVEDV),Minnesota living with heart failure questionnaire(MLHFQ)score,prothrombin time(PT),D-dimer(D-D)and activated partial thromboplastin time(APTT),and the incidence of adverse reactions were compared between the two groups.Results The total effective rate of the combination group(93.33%,42/45)was higher than that of the single group(77.78%,35/45),P<0.05.After treatment,the combination group had lower the LVEDV and higher LVEF compared with the single group(P<0.05).After treatment,the combination group had lower MLHFQ score compared with the single group(P<0.05).After treatment,the PT and APTT in the combination group were longer than those in the single group,and the D-D level was lower than that in the single group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions Low-dose aspirin combined with sacubitril/valsartan in patients with chronic heart failure can improve clinical therapeutic effect,coagulation function,cardiac function and quality of life.