沙库巴曲缬沙坦联合酒石酸美托洛尔治疗高血压伴心力衰竭患者的效果

Effects of Sacubitril/Valsartan combined with Metoprolol tartrate in treatment of patients with hypertension and heart failure

目的:观察沙库巴曲缬沙坦联合酒石酸美托洛尔治疗高血压伴心力衰竭患者的效果。方法:选取2021年1月至2023年1月该院收治的80例高血压伴心力衰竭患者进行前瞻性研究,按照随机数字表法分为对照组与观察组各40例。对照组采用酒石酸美托洛尔片治疗,观察组在对照组基础上联合沙库巴曲缬沙坦钠片治疗。比较两组临床疗效,治疗前后血压、心功能指标[左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、心排血量(CO)]、心肌损伤标志物[N-末端脑钠肽前体(NT-proBNP)、肌钙蛋白I(cTnI)、脑钠肽(BNP)]水平,以及不良反应发生率。结果:观察组治疗总有效率为95.00%(38/40),高于对照组的77.50%(31/40),差异有统计学意义(P<0.05);治疗后,两组舒张压、收缩压水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组LVESD、LVEDD水平均低于治疗前,且观察组低于对照组,两组LVEF、CO水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);两组NT-proBNP、cTnI、BNP水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:沙库巴曲缬沙坦联合酒石酸美托洛尔治疗高血压伴心力衰竭患者可提高临床疗效,改善心功能指标水平,降低血压和心肌损伤标志物水平,其效果优于单纯酒石酸美托洛尔治疗。

Objective:To observe effects of Sacubitril/Valsartan combined with Metoprolol tartrate in treatment of patients with hypertension and heart failure.Methods:A prospective study was conducted on 80 patients with hypertension and heart failure admitted to the hospital from January 2021 to January 2023.According to the random number table method,they were divided into control group and observation group,40 cases in each group.The control group was treated with Metoprolol tartrate tablets,while the observation group was treated with Sacubitril/Valsartan sodium tablets on the basis of that of the control group.The clinical efficacy,the blood pressure,the cardiac function indexes[left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),cardiac output(CO)],the myocardial injury markers[N-terminal pro-brain natriuretic peptide(NT-proBNP),troponin I(cTnI),brain natriuretic peptide(BNP)]levels before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of treatment in the observation group was 95.00%(38/40),which was higher than 77.50%(31/40)in the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of diastolic blood pressure and systolic blood pressure in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of LVESD and LVEDD in the two groups were lower than those before the treatment,and those in the observation group were lower than those in the control group;the levels of LVEF and CO in the two groups were higher than those before the treatment,and those in the observation group were higher than those in the control group;and the differences were statistically significant(P<0.05).The levels of NT-proBNP,cTnI and BNP in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Sacubitril/Valsartan combined with Metoprolol tartrate in the treatment of the patients with hypertension and heart failure can improve the clinical efficacy,improve the levels of cardiac function indexes,and reduce the levels of blood pressure and myocardial injury markers.Moreover,it is superior to simple Metoprolol tartrate treatment.