左西孟旦联合沙库巴曲缬沙坦治疗难治性心衰患者的临床效果观察  

Observation on clinical effect of levosimendan combined with sacubitril and valsartan on patients with refractory heart failure

作　　者：尚晓峰 高涵翔[2] 杨威 刘凯元 张锦[2] 孔繁玲 胡婧 SHANG Xiao-feng;GAO Han-xiang;YANG Wei(Second Department of Cardiovascular Medicine,Zhangye People's Hospital Affiliated to Hexi University,Zhangye 734000,China)

机构地区：[1]河西学院附属张掖人民医院心血管内二科,734000 [2]兰州大学第一医院心血管内科,730000

出　　处：《中国现代药物应用》2022年第15期24-27,共4页Chinese Journal of Modern Drug Application

基　　金：甘肃省自然科学基金(项目编号:21JR1RG307)。

摘　　要：目的总结和分析难治性心力衰竭(心衰)患者采取左西孟旦联合沙库巴曲缬沙坦治疗的临床效果。方法120例难治性心衰患者,根据治疗方案的不同分为常规治疗组和联合治疗组,每组60例。常规治疗组患者采用常规治疗方法,联合治疗组患者采用左西孟旦联合沙库巴曲缬沙坦治疗。对比两组患者治疗前后血管内皮生长因子(VEGF)、静息灌注总评分(SRS)评分,治疗前后左室射血分数(LVEF)、外周血N-末端脑钠肽前体(NT-proBNP)、6 min步行试验距离(6MWT),治疗效果。结果治疗前,两组患者的VEGF和SRS评分对比差异无统计学意义(P>0.05);治疗后3个月,联合治疗组的VEGF(116.2±2.6)pg/ml高于常规治疗组的(90.5±10.1)pg/ml,SRS评分(9.5±2.3)分低于常规治疗组的(13.9±2.0)分,差异具有统计学意义(P<0.05)。治疗前,两组患者的LVEF、NT-proBNP、6MWT对比差异无统计学意义(P>0.05);治疗后3个月,联合治疗组的LVEF(44.3±2.5)%高于常规治疗组的(36.9±4.6)%,NT-proBNP(2655.3±168.2)pg/ml低于常规治疗组的(4305.3±124.6)pg/ml,6MWT(418.8±12.3)m长于常规治疗组的(253.9±12.0)m,差异均有统计学意义(P<0.05)。联合治疗组的治疗总有效率为91.7%(55/60),高于常规治疗组的71.7%(43/60),差异具有统计学意义(P<0.05)。结论左西孟旦联合沙库巴曲缬沙坦在难治性心衰患者中应用效果较好,能够明显改善患者的心功能指标,具有较高的临床实用价值。Objective To summarize and analyze the clinical effect of levosimendan combined with sacubitril and valsartan on patients with refractory heart failure.Methods A total of 120 patients with refractory heart failure were divided into conventional treatment group and combined treatment group according to different treatment regimens,with 60 cases in each group.Patients in the conventional treatment group were treated with conventional treatment methods,and patients in the combined treatment group were treated with levosimendan combined with sacubitril and valsartan.Both groups were compared in terms of vascular endothelial growth factor(VEGF),summed rest score(SRS),left ventricular ejection fraction(LVEF),N-terminal pro-brain natriuretic peptide(NT-proBNP),and left ventricular ejection fraction(LVEF),6 min walking test distance(6MWT)before and after treatment,and therapeutic effect.Results Before treatment,there was no statistically significant difference in VEGF and SRS scores between the two groups(P>0.05).3 months after treatment,the VEGF(116.2±2.6)pg/ml in the combined treatment group was higher than(90.5±10.1)pg/ml in the conventional treatment group,and the SRS score(9.5±2.3)points was lower than(13.9±2.0)points in the conventional treatment group.All the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in LVEF,NT-proBNP and 6MWT between the two groups(P>0.05).3 months after treatment,the LVEF(44.3±2.5)%in the combined treatment group was higher than(36.9±4.6)%in the conventional treatment group,and the NT-proBNP(2655.3±168.2)pg/ml was lower than(4305.3±124.6)pg/ml in the conventional treatment group,and the 6MWT(418.8±12.3)m was longer than(253.9±12.0)m in the conventional treatment group.All the differences were statistically significant(P<0.05).The total effective rate of the combined treatment group was 91.7%(55/60),which was higher than 71.7%(43/60)of the conventional treatment group,and the difference was statistically signifi

关 键 词：左西孟旦 沙库巴曲缬沙坦 难治性心力衰竭 心功能 

分 类 号：R541.6[医药卫生—心血管疾病]