沙库巴曲缬沙坦联合美托洛尔对老年冠心病心力衰竭患者心功能及生活质量的影响  

Effects of sacubitril/valsartan combined with metoprolol on cardiac function and quality of life in elderly patients with coronary heart disease complicated with heart failure

作　　者：韩妹 熊璐[1] 王萍[1] 林文婷[1] 陈积雄[1] HAN Mei;XIONG Lu;WANG Ping;LIN Wen-ting;CHEN Ji-xiong(Medical Care Center,Hainan General Hospital,Haikou 570208,Hainan,China)

机构地区：[1]海南省人民医院医疗保健中心,海南海口570208

出　　处：《川北医学院学报》2021年第8期1041-1044,共4页Journal of North Sichuan Medical College

基　　金：海南自然科学基金面上项目(817321)。

摘　　要：目的:探究沙库巴曲缬沙坦联合美托洛尔对老年冠心病心力衰竭患者心功能及生活质量的影响。方法:选取124例老年冠心病心力衰竭患者为研究对象,依据治疗方式不同分为观察组和对照组,每组各62例。观察组采用沙库巴曲缬沙坦联合美托洛尔治疗;对照组采用美托洛尔治疗,疗程12周。比较两组患者临床疗效、治疗前后心功能指标、神经内分泌因子水平、SF-36生活质量评价量表(QLS)评分及不良反应。结果:观察组患者治疗的总有效率高于对照组(P<0.05)。治疗后,两组患者6 min步行试验(6MWT)距离、左心室射血分数(LVEF)均升高,且观察组高于对照组(P<0.05);左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)均减小,且观察组小于对照组(P<0.05);脑钠肽(BNP)、超敏C反应蛋白(hs-CRP)、血管紧张素II(Ang II)水平均降低,且观察组低于对照组(P<0.05);QLS各维度评分均升高,且观察组高于对照组(P<0.05)。两组患者治疗期间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美托洛尔可提高老年冠心病心力衰竭患者的治疗效果率,有效改善患者心功能,降低神经内分泌激素水平,提高生活质量,且不增加不良反应的发生率,值得临床推广。Objective:To explore the effects of sacubitril/valsartan combined with metoprolol on cardiac function and quality of life in elderly patients with coronary heart disease complicated with heart failure.Methods:A total of 124 elderly patients with coronary heart disease complicated with heart failure were selected as the research objects,and they were divided into the control group and the observation group according to different treatment methods,62 cases in each group.The control group was treated with oral administration of metoprolol,whereas the observation group was combined with sacubitril/valsartan on the basis of the control group,the course of treatment was 12 weeks.The clinical efficacy,cardiac function indexes before and after treatment,neuroendocrine factors,SF-36 quality of life score(QLS)and adverse reactions were compared between the two groups.Results:After treatment,the total clinical effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the 6MWT and LVEF of the two groups were increased,and the observation group were higher than the control group(P<0.05).The left ventricular end diastolic diameter(LVEDD)and the left ventricular end systolic diameter(LVESD)of the two groups were decreased,and the observation group was smaller than the control group(P<0.05).The levels of BNP,hs-CRP and Ang II of the two groups were decreased,and the observation group were lower than the control group(P<0.05).The scores of each dimension of QLS of the two groups were increased,and the observation group were higher than the control group(P<0.05).There were no significant differences in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion:Sacubitril/valsartan with metoprolol can improve the treatment effect rate of elderly patients with coronary heart disease and heart failure,effectively improve the cardiac function,reduce the level of neuroendocrine hormone,improve the quality of life,and does not increase the incidence of adverse reacti

关 键 词：冠心病 心功能 神经内分泌激素 心力衰竭 沙库巴曲缬沙坦 美托洛尔 

分 类 号：R541.4[医药卫生—心血管疾病]