诺欣妥联合琥珀酸美托洛尔缓释片治疗慢性充血性心衰的效果及对患者心功能和NT-proBNP的影响探讨  

Effect of Entresto combined with metoprolol succinate sustained-release tablets in the treatment of chronic congestive heart failure and its influence on cardiac function and NT-proBNP of patients

作　　者：肖宁 苏怀勇 XIAO Ning;SU Huai-yong(Department of Cardiology,Yanggu County People's Hospital,Liaocheng 252300,China)

机构地区：[1]阳谷县人民医院心内科一区,252300

出　　处：《中国实用医药》2022年第18期29-32,共4页China Practical Medicine

摘　　要：目的 探讨沙库巴曲缬沙坦钠片(商品名:诺欣妥)联合琥珀酸美托洛尔缓释片治疗慢性充血性心力衰竭(心衰)的效果及对患者心功能和N末端脑钠肽前体(NT-proBNP)的影响。方法 100例慢性充血性心衰患者,采用随机数字表法分为观察组和对照组,各50例。对照组患者采用琥珀酸美托洛尔缓释片治疗,观察组采用诺欣妥联合琥珀酸美托洛尔缓释片治疗。比较两组患者临床疗效及治疗前后心功能指标[左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)]、6 min步行距离、NT-proBNP水平、炎性因子[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)]水平。结果 观察组治疗总有效率为90.00%,高于对照组的70.00%,差异具有统计学意义(P<0.05)。治疗后,两组LVESD、LVEDD均小于治疗前, LVEF高于治疗前,且观察组LVESD(40.23±2.73)mm,LVEDD(47.23±4.21)mm均小于对照组的(44.29±3.98)、(51.23±3.93)mm, LVEF(56.72±5.83)%高于对照组的(47.22±4.85)%,差异具有统计学意义(P<0.05)。治疗后,两组6 min步行距离长于治疗前,NT-proBNP水平低于治疗前,且观察组6 min步行距离(308.71±34.29)m长于对照组的(267.42±28.71)m,NT-proBNP水平(434.92±59.13)pg/ml低于对照组的(528.24±54.29)pg/ml,差异具有统计学意义(P<0.05)。治疗后,两组hs-CRP、TNF-α水平均低于治疗前,且观察组hs-CRP(3.22±1.41)mg/L、TNF-α(13.49±3.56)ng/L低于对照组的(4.93±1.79)mg/L、(19.81±3.17)ng/L,差异具有统计学意义(P<0.05)。结论 慢性充血性心衰患者应用诺欣妥联合琥珀酸美托洛尔缓释片治疗可增强治疗效果,改善心功能,提高运动功能,降低NT-proBNP水平,且可保持血压、心率的稳定,减轻炎性反应程度,价值显著。Objective To discuss the effect of sacubitril valsartan sodium tablets trade name: Entresto combined with metoprolol succinate sustained-release tablets in the treatment of chronic congestive heart failure and its influence on cardiac function and N-terminal pro-brain natriuretic peptide(NT-proBNP) of patients.Methods A total of 100 patients with chronic congestive heart failure were divided into observation group and control group by random numerical table, with 50 cases in each group. Patients in the control group were treated with metoprolol succinate sustained-release tablets, and patients in the observation group were treated with Entresto combined with metoprolol succinate sustained-release tablets. Both groups were compared in terms of clinical efficacy and cardiac function indicators [left ventricular end-systolic diameter(LVESD), left ventricular end-diastolic diameter(LVEDD), left ventricular ejection fraction(LVEF)], 6-min walking distance,NT-proBNP level, inflammatory factors [high-sensitivity C-reactive protein(hs-CRP), tumor necrosis factor-α(TNF-α)] levels before and after treatment. Results The total effective rate of treatment in the observation group was 90.00%, which was higher than 70.00% in the control group, and the difference was statistically significant(P<0.05). After treatment, the LVESD and LVEDD in both groups were smaller than those before treatment in this group, and LVEF was higher than that before treatment in this group;the LVESD(40.23±2.73) mm and LVEDD(47.23±4.21) mm in observation group were smaller than(44.29±3.98) and(51.23±3.93) mm in control group,and the LVEF(56.72±5.83)% was higher than(47.22±4.85)% in the control group;all the differences were statistically significant(P<0.05). After treatment, the 6-min walking distance in the two groups was longer than that before treatment in this group, and the level of NT-proBNP was lower than that before treatment in this group;the 6-min walking distance(308.71±34.29) m in the observation group was longer than(267.42±28.7

关 键 词：慢性充血性心力衰竭 琥珀酸美托洛尔缓释片 沙库巴曲缬沙坦钠片 心功能 N末端脑钠肽前体 

分 类 号：R541.6[医药卫生—心血管疾病]