沙库巴曲缬沙坦联合卡维地洛治疗慢性心力衰竭的效果及对心功能和血清相关指标的影响

Effect of sacubitril valsartan combined with carvedilol in the treatment of chronic heart failure and its effect on cardiac function and serum related indexes

目的 观察沙库巴曲缬沙坦联合卡维地洛治疗慢性心力衰竭(CHF)的效果及对心功能和血清相关指标的影响。方法 选取2021年8月—2022年8月齐齐哈尔市第一医院诊治的CHF患者74例,按随机数字表法分为观察组和对照组各37例。对照组予以卡维地洛治疗,观察组在对照组基础上加用沙库巴曲缬沙坦治疗,2组均治疗3个月。比较2组临床疗效,治疗前后心功能、心肌损伤标志物、炎性因子水平及不良反应。结果 观察组总有效率为94.59%,高于对照组的78.38%(χ^(2)=4.163,P=0.041);治疗3个月后,2组左室射血分数(LVEF)高于治疗前,左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、左房内径(LAD)及心肌肌钙蛋白(cTnT)、肌酸激酶同工酶(CK-MB)、降钙素原(PCT)、C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平低于治疗前,且观察组LVEF高于对照组,LVESD、LVEDD、LAD及cTnT、CK-MB、PCT、CRP、IL-6、TNF-α水平低于对照组(P<0.01);观察组与对照组不良反应总发生率比较差异无统计学意义(5.41%vs.10.81%,χ^(2)=0.151,P=0.670)。结论 沙库巴曲缬沙坦联合卡维地洛治疗CHF效果显著,可提升心功能,减轻心肌损伤与炎性反应,且无严重不良反应,安全性高。

Objective To observe the effect of sacubitril valsartan combined with carvedilol in the treatment of CHF and its influence on cardiac function and serum related indexes.Methods Seventy-four cases of CHF patients diagnosed and treated in the First Hospital of Qiqihar from August 2021 to August 2022 were selected and they were divided into the observation group and the control group according to the method of random number table,37 cases in each group.The control group was treated with carvedilol,and the observation group was treated with sacubitril valsartan on the basis of the control group,and both groups were treated continuously for 3 months.The clinical efficacy,cardiac function,markers of myocardial injury,inflammatory factor levels before and after treatment and adverse reactions were compared between the two groups.Results The total effective rate of treatment in the observation group was 94.59%,which was higher than 78.38% in the control group(χ^(2)=4.163,P=0.041).After 3 months of treatment,LVEF in the two groups were higher than before treatment,LVESD,LVEDD,LAD,and the levels of cTnT,CK-MB,PCT,CRP,IL-6,and TNF-α were lower than before treatment,and LVEF in the observation group was higher than that in the control group,LVESD,LVEDD,LAD and the levels of cTnT,CK-MB,PCT,CRP,IL-6,and TNF-α were lower than those in the control group(P<0.01).There was no significant difference in the total incidence of adverse reactions between the observation group and the control group(5.41% vs.10.81%,χ^(2)=0.151,P=0.670).Conclusion The treatment of CHF patients with sacubitril valsartan combined with carvedilol has significant effect,which can significantly improve the cardiac function of patients,reduce myocardial injury and inflammatory response,and no serious adverse effects,high safety.