维利西呱联合沙库巴曲缬沙坦对心力衰竭患者心功能及血液流变学的影响

Effect of vericiguat combined with sacubitril valsartan on cardiac function and hemorheology in patients with heart failure

目的 观察维利西呱联合沙库巴曲缬沙坦对心力衰竭(HF)患者心功能及血液流变学的影响。方法 根据随机数字表法将2021年7月—2023年7月宁夏医科大学总医院收治的HF患者80例进行分组,分为观察组和对照组各40例。在常规对症治疗基础上,对照组采用沙库巴曲缬沙坦钠片治疗,观察组在对照组基础上采用维利西呱片治疗,2组均连续用药2个月。比较2组治疗前后心功能指标[左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、心输出量(CO)、心率(HR)、心脏指数(CI)]、血清学指标[心肌肌钙蛋白T(cTnT)、超敏C反应蛋白(hs-CRP)、N末端脑钠肽前体(NT-proBNP)]、血液流变学指标[血浆纤维蛋白原(Fib)、血浆黏度(PV)、全血低切黏度(LBV)、全血高切黏度(HBV)]、明尼苏达心力衰竭生活质量问卷(MLHFQ)评分、6 min步行距离(6MWD)。结果 治疗2个月后,2组LVEF较治疗前升高,LVEDD、LVESD较治疗前缩小,且观察组LVEF高于对照组,LVEDD、LVESD小于对照组(P<0.01);2组CO、CI较治疗前升高,HR较治疗前下降,且观察组升高/下降幅度大于对照组(P<0.01);2组血清cTnT、hs-CRP、NT-proBNP水平均明显低于治疗前,且观察组低于对照组(P<0.01);2组血浆Fib水平与PV、LBV、HBV低于治疗前,且观察组降低幅度大于对照组(P<0.01);2组MLHFQ评分低于治疗前,6MWD较治疗前延长,且观察组下降/延长幅度大于对照组(P<0.01)。结论 采用维利西呱联合沙库巴曲缬沙坦治疗HF可提高患者心功能,改善机体血液流变学,并减轻心肌损伤,提高患者生活质量和运动耐量。

Objective To observe the effect of vericiguat combined with sacubitril valsartan on cardiac function and hemorheology in patients with heart failure.Methods A total of 80 patients with heart failure admitted to the General Hospital of Ningxia Medical University from July 2021 to July 2023 were selected and divided into the observation group and the control group by random number table method,40 cases in each group.On the basis of conventional symptomatic treatment,the control group was treated with sacubitril valsartan sodium tablets,and the observation group was treated with vericiguat tablets on the basis of the control group.The two groups were continuously medicated for 2 months.Cardiac function indexes(LVEF,LVEDD,LVESD,CO,HR,CI),serology indexes(cTnT,hs-CRP,NT-proBNP),hemorheology indexes(plasma Fib,PV,LBV,HBV),MLHFQ scores,and 6MWD before and after the treatment were compared between the two groups.Results After 2 months of treatment,the LVEF of the two groups was higher than that before treatment,LVEDD and LVESD were smaller than those before treatment,and the LVEF of the observation group was higher than that of the control group,LVEDD and LVESD were smaller than those of the control group(P<0.01);CO and CI of the two groups were higher than those before treatment,and HR was lower than that before treatment,and the magnitude of the increase/decrease of the observation group were greater than those of the control group(P<0.01);Serum cTnT,hs-CRP,NT-proBNP levels of the two groups were significantly lower than those before treatment,and the observation group were lower than those in the control group(P<0.01);Plasma Fib level and PV,LBV,HBV of the two groups were lower than those before treatment,and the decreased in the observation group was greater than that in the control group(P<0.01);MLHFQ scores in the two groups were lower than those before treatment,and 6MWD was increased compared with that before treatment,and the decreased/increased in the observation group were greater than those in the control group(P<0.01).Conclusion The treatment of heart failure with vericiguat combined with sacubitril valsartan can improve the cardiac function of patients,improve hemorheology and reduce myocoardial injury,and improve the quality of life and exercise tolerance of patients.