沙库巴曲缬沙坦联合达格列净治疗心力衰竭

A randomized controlled study of sacubitril valsartan in combination with dagliflozin in the treatment of heart failure

目的探讨沙库巴曲缬沙坦与达格列净联合治疗心力衰竭的疗效及对患者心功能、炎症因子水平的影响。方法以我院2021年1月至2023年3月收治的120例心力衰竭患者为研究对象,依据随机抽签法分为参照组(n=60)、试验组(n=60)。参照组给予沙库巴曲缬沙坦,试验组给予达格列净+沙库巴曲缬沙坦。比较两组临床疗效、治疗前后心功能(NYHA)分级、左心室舒张末内径(LVEDD)、左心室射血分数(LVEF)、左心室收缩末内径(LVESD)、舒张期室间隔厚度(IVST)、左心室后壁厚度(LVPWT)、左室质量指数(LVMI)、细胞间黏附分子(ICAM-1)、超敏C反应蛋白(Hs-CRP)、核因子-κB(NF-κB)、白细胞介素33(IL-33)、肿瘤坏死因子(TNF-α)水平。结果治疗后试验组临床总有效率96.67%高于参照组86.67%,差异具有统计学意义(P<0.05);治疗后两组心功能指标LVESD、LVEDD水平明显降低且试验组更低,LVEF水平明显升高且试验组更高,其中试验组改善幅度更为显著,差异具有统计学意义(P<0.05);治疗后试验组NYHA分级改善程度大于参照组,差异具有统计学意义(P<0.05);治疗后两组心室重塑指标LVMI水平明显升高,IVST、LVPWT水平明显降低,其中试验组改善幅度更为显著,差异具有统计学意义(P<0.05);治疗后试验组血清炎性因子指标IL-33、NF-κB、Hs-CRP、TNF-α、ICAM-1水平降低幅度均大于参照组,差异具有统计学意义(P<0.05)。结论达格列净+沙库巴曲缬沙坦治疗心力衰竭疗效确切,可改善患者心功能及心室重塑相关指标,抑制体内炎症,有利于病情恢复。

Objective To explore the efficacy of the combination of sacubitril valsartan and dagliflozin in the treatment of heart failure and the effects on patients'cardiac function and inflammatory factor levels.Methods One hundred and twenty cases of heart failure patients admitted to our hospital from January 2021 to March 2023 were used as study subjects,and were divided into reference group(60 cases)and experimental group(60 cases)based on the random draw method.The reference group was given sacubitril valsartan,and the experimental group was given dagliflozin+sacubitril valsartan.Clinical efficacy,cardiac function(NYHA)classification before and after treatment,left ventricular end-diastolic internal diameter(LVEDD),left ventricular ejection fraction(LVEF),left ventricular end-systolic internal diameter(LVESD),diastolic interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular mass index(LVMI),and intercellular adhesion molecule(ICAM-1)were compared between the two groups,hypersensitive C-reactive protein(Hs-CRP),nuclear factor-κB(NF-κB),interleukin 33(IL-33),and tumor necrosis factor(TNF-α)levels.Results The total clinical effective rate of the experimental group after treatment was 96.67%higher than that of the reference group,which was 86.67%,and the difference was statistically significant(P<0.05).After treatment,the levels of cardiac function indexes LVESD and LVEDD were significantly decreased,while the levels of LVEF were significantly increased in the two groups,and the improvement of experimental group was more significant,the difference was statistically significant(P<0.05).The improvement of NYHA grade in experimental group was greater than that in reference group after treatment,and the difference was statistically significant(P<0.05).After treatment,the levels of cardiac function indicators LVESD and LVEDD in both groups decreased significantly,and the experimental group had lower levels,the level of LVEF increased significantly and the experimental group had higher levels,and the differences were statistically significant(P<0.05).After treatment,the levels of serum inflammatory factors IL-33,Hs-CRP,TNF-αand ICAM-1 in experimental groups were reduced more than those in the control group,with statistical significance(P<0.05).Conclusions Sakobattriovalsartan+Dagliazine is effective in the treatment of heart failure,which can effectively improve cardiac function and ventricular remodeling related indicators,inhibit inflammation in vivo,and contribute to the recovery of the disease.