沙库巴曲缬沙坦联合替米沙坦治疗扩张型心肌病的效果及对心肌纤维化、心室重构的影响

Effect of sacubitril valsartan combined with telmisartan in the treatment of dilated cardiomyopathy and its influences on myocardial fibrosis and ventricular remodeling

目的探讨沙库巴曲缬沙坦联合替米沙坦治疗扩张型心肌病(DCM)的效果及对心肌纤维化、心室重构的影响。方法选取2020年1月至12月收治的60例DCM患者为研究对象,依据入院编号的奇偶性将其分为对照组与观察组,各30例。对照组采用替米沙坦治疗,观察组在对照组基础上联合沙库巴曲缬沙坦治疗。比较两组的治疗效果。结果治疗后,两组的N-末端脑钠肽前体(NT-proBNP)、可溶性生长刺激表达基因2蛋白(sST2)、基质金属蛋白酶-9(MMP-9)水平均降低,金属蛋白酶组织抑制因子-1(TIMP-1)水平均升高,且观察组优于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)小于对照组,心排血量(CO)、左室射血分数(LVEF)、每搏输出量(SV)高于对照组,差异具有统计学意义(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。观察组的治疗总有效率高于对照组,差异具有统计学意义(P<0.05)。结论沙库巴曲缬沙坦联合替米沙坦治疗DCM的效果较好,可抑制心室重构,缓解心肌纤维化,提升心脏功能,具有重要的临床应用价值。

Objective To investigate the effect of sacubitril valsartan combined with telmisartan in the treatment of dilated cardiomyopathy(DCM)and its influences on myocardial fibrosis and ventricular remodeling.Methods A total of 60 DCM patients admitted from January to December 2020 were selected as the research objects.According to the parity of admission number,the patients were divided into control group and observation group,with 30 cases in each group.The control group was treated with telmisartan,and the observation group was treated with sacubitril valsartan on the basis of the control group.The therapeutic effects of the two groups were compared.Results After treatment,the levels of N-terminal pro-brain natriuretic peptide(NT-proBNP),soluble growth stimulating gene 2 protein(sST2)and matrix metalloproteinase-9(MMP-9)in the two groups decreased,the level of tissue inhibitor of metalloproteinase-1(TIMP-1)increased,those in the observation group were better than the control group,and the differences were statistically significant(P<0.05).After treatment,the left ventricular end-diastolic diameter(LVEDD)and left ventricle end-systolic diameter(LVESD)in the observation group were smaller than those in the control group,the cardiac output(CO),left ventricular ejection fraction(LVEF)and stroke volume(SV)were higher than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).The total effective rate of treatment in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Sacubitril valsartan combined with telmisartan is effective in the treatment of DCM,which can inhibit ventricular remodeling,relieve myocardial fibrosis and improve cardiac function.It has important clinical application value.