沙库巴曲缬沙坦联合比索洛尔治疗慢性心力衰竭的临床研究

目的探讨沙库巴曲缬沙坦联合比索洛尔治疗慢性心力衰竭的临床效果。方法选取2017年12月—2018年3月在河南科技大学第一附属医院就诊的慢性心力衰竭患者89例,根据治疗方案不同分成对照组(44例)和治疗组(45例)。对照组患者晨起口服富马酸比索洛尔片,1片/次,1次/d;治疗组患者在对照组基础上口服沙库巴曲缬沙坦钠片,起始剂量50 mg/次,2次/d,之后增加50 mg/2周,直至200 mg/次。两组患者均连续治疗4周。观察两组患者临床疗效,同时比较治疗前后两组患者6min步行距离、明尼苏达生活量表(MLHFQ)评分和血清学指标。结果治疗后,对照组临床有效率为81.82%,显著低于治疗组的95.56%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者6 min步行距离显著增加,MLHFQ评分显著降低,同组比较差异具有统计学意义(P0.05),且治疗后治疗组患者6min步行距离和MLHFQ评分明显优于对照组(P0.05)。治疗后,两组患者N端B型脑钠肽(NT-pro BNP)、细胞间黏附分子-1(ICAM-1)和醛固酮(ALD)血清水平显著降低(P0.05),且治疗后治疗组患者NT-pro BNP、ICAM-1和ALD水平明显低于对照组(P0.05)。结论沙库巴曲缬沙坦联合比索洛尔治疗慢性心力衰竭临床疗效好、安全性高,可有效改善患者生活质量,具有一定的临床推广应用价值。

Clinical study on sacubitril valsartan combined with bisoprolol in treatment of chronic heart failure

Objective To investigate the clinical effects of sacubitril valsartan combined with bisoprolol in treatment of chronic heart failure. Methods Patients (89 cases) with chronic heart failure in the First Affiliated Hospital of Henan University of Science and Technology from December 2017 to March 2018 were divided into control (44 cases) and treatment (45 cases) groups according to different treatments. Patients in the control group were po administered with Bisoprolol Fumarate Tablets in the morning, 1 tablet/time, once daily. Patients in the treatment group were po administered with Sacubitril Valsartan Sodium Tablets on the basis of the control group, and the initial dose was 50 mg/time, twice daily, then increased by 50 mg every 2 weeks until 200 mg/time. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and 6 min walking distance, MLHFQ scores, serological indicators in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 81.82%, which was significantly lower than 95.56% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the 6 min walking distance in two groups were significantly increased, but MLHFQ scores were significantly decreased, and the difference was statistically significant in the same group (P<0.05). After treatment, the 6 min walking distance and MLHFQ scores in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the serum NT-proBNP, ICAM-1, and ALD levels in two groups were significantly decreased (P<0.05), and the NT-proBNP, ICAM-1, and ALD levels in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Sacubitril valsartan combined with bisoprolol in treatment of chronic heart failure has significant curative effect and high safety, can improve the quality of life, which has a certain clinical application value.