沙库巴曲缬沙坦与美托洛尔联合应用于老年冠心病心力衰竭患者治疗中的效果观察

Observation of the Therapeutic Effect of the Combination of Sacubitril Valsartan and Metoprolol in Elderly Patients with Coronary Heart Disease and Heart Failure

目的探讨沙库巴曲缬沙坦与美托洛尔联合应用于老年冠心病心力衰竭(HF)患者治疗中的效果。方法选取2023年1—12月济南北城医院收治的120例老年冠心病HF患者为研究对象,按随机数字表法将其分为观察组与对照组,各60例。两组入院后均给予常规治疗,对照组采用美托洛尔治疗,观察组在对照组的基础上联合沙库巴曲缬沙坦治疗。比较两组患者的临床疗效、心功能指标、神经内分泌因子水平及不良反应发生情况。结果观察组治疗总有效率为90.33%,高于对照组的70.00%,差异有统计学意义(P<0.05)。治疗3个月后,两组左心室收缩末期内径、左心室舒张末期内径均短于治疗前,且观察组均短于对照组,差异有统计学意义(P<0.05);两组左心室射血分数均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);两组N末端B型利钠肽原、醛固酮、血管紧张素Ⅱ水平均低于治疗前,且观察组均低于对照组,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与美托洛尔联合治疗老年冠心病HF的效果确切,可改善患者的心功能,调节神经内分泌因子水平,且安全性较高。

Objective Exploring the efficacy of the combination of sacubitril valsartan and metoprolol in the treatment of elderly patients with coronary heart disease and heart failure(HF).Methods Selecting 120 elderly patients with coronary HF admitted to Jinan Beicheng Hospital from January to December 2023 as the research subjects,according to the random number table method,they were divided into an observation group and a control group,with 60 cases in each group.Both groups received routine treatment upon admission,with the control group receiving oral metoprolol and the observation group receiving a combination of sacubitril valsartan on the basis of the control group.The clinical efficacy,cardiac function indicators,levels of neuroendocrine factors and the occurrence adverse reaction were Compared between two groups of patients.Results The total effective rate of the observation group was 90.33%,which was higher than the control group's 70.00%,the difference was statistically significant(P<0.05).After 3 months of treatment,the levels of left ventricular end systolic diameter and left ventricular end diastolic diameter in both groups were shorter than before treatment,and the observation group were shorter than those in the control group,the difference was statistically significant(P<0.05);the left ventricular ejection fraction in both groups were higher than before treatment,and the observation group was higher than that in the control group,the differences were statistically significant(P<0.05);the levels of N-terminal pro-brain natriuretic peptid,aldosterone,and AngiotensinⅡin both groups were lower than before treatment,and the observation group was lower than that in the control group,the differences were statistically significant(P<0.05).Comparison of incidence of adverse reactions between two groups,the difference was not statistically significant(P>0.05).Conclusion The combination of sacubitril valsartan with metoprolol has a definite effect on the treatment of elderly patients with coronary heart disease and HF,it can improve the patient's heart function,regulate the level of neuroendocrine factors,and has high safety.