沙库巴曲缬沙坦联合芪苈强心胶囊治疗扩张型心肌病的效果  

Curative effect of sacubitril valsartan combined with Qili Qiangxin capsules on dilated cardiomyopathy

作　　者：赵运[1] 邢雪 董静[1] 康启 Zhao Yun;Xing Xue;Dong Jing;Kang Qi(Department of Cardiology,Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xianyang 712000,China)

机构地区：[1]陕西中医药大学第二附属医院心内三科,咸阳712000

出　　处：《国际医药卫生导报》2024年第10期1677-1681,共5页International Medicine and Health Guidance News

基　　金：陕西省重点研发计划项目(2023-YBSF-674)。

摘　　要：目的探讨沙库巴曲缬沙坦联合芪苈强心胶囊治疗扩张型心肌病(DCM)的效果及对心肌纤维化、心室重构(VR)的影响。方法选取2019年1月至2023年1月陕西中医药大学第二附属医院收治的62例DCM患者作为研究对象,采用随机数字表法将患者分为研究组和对照组各31例。对照组男20例,女11例;年龄(45.72±4.89)岁;美国纽约心脏病协会(NYHA)心功能分级:Ⅱ级15例,Ⅲ级16例。研究组男14例,女17例;年龄(46.91±5.36)岁;NYHA心功能分级:Ⅱ级12例,Ⅲ级19例。对照组给予强心、利尿、β受体阻滞剂、醛固酮抑制剂和沙库巴曲缬沙坦钠口服治疗;研究组在对照组基础上给予芪苈强心胶囊口服治疗;两组均持续治疗3个月。比较两组临床疗效,治疗前后左心室射血分数(LVEF)、左心室舒张末期容积(LVEDV)、左心室舒张末期内径(LVEDD)、血清N末端脑钠肽前体(NT-proBNP)、层粘蛋白(LN)、透明质酸(HA)、转化生长因子-β1(TGF-β1)、6 min步行距离(6MWD)、生活质量综合评定问卷(GQOLI-74)评分及治疗期间不良反应发生率。采用独立样本t检验、配对样本t检验和χ^(2)检验。结果研究组总有效率为93.55%(29/31),高于对照组的74.19%(23/31)(P<0.05);治疗后,研究组LVEF高于对照组[(47.11±5.68)%比(43.92±4.35)%],LVEDV、LVEDD均低于对照组[(145.38±16.37)ml比(163.09±20.42)ml、(45.90±4.26)mm比(49.21±5.12)mm](均P<0.05);治疗后,研究组LN、HA和TGF-β1均低于对照组[(153.82±11.24)μg/L比(186.31±14.73)μg/L、(165.48±16.75)μg/L比(197.06±19.62)μg/L、(36.91±3.77)μg/L比(40.52±2.63)μg/L](均P<0.05);治疗后,研究组血清NT-proBNP低于对照组[(827.95±76.13)ng/L比(932.74±59.25)ng/L],GQOLI-74评分高于对照组[(89.61±3.17)分比(81.83±4.92)分],6MWD长于对照组[(346.75±32.45)m比(308.26±29.71)m](均P<0.05);研究组治疗期间不良反应总发生率为19.35%(6/31),与对照组的12.90%(4/31)比较,差异无统计学意义(P>0.05)。结论沙库巴曲�Objective To explore the curative effect of sacubitril valsartan combined with Qili Qiangxin capsules on dilated cardiomyopathy(DCM)and its influences on myocardial fibrosis and ventricular remodeling(VR).Methods A total of 62 patients with DCM admitted to Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine were enrolled as the research objects between January 2019 and January 2023.According to the random number table method,they were divided into a study group and a control group with 31 cases in each group.In the control group,there were 20 males and 11 females,aged(45.72±4.89)years,New York Heart Association(NYHA)cardiac function classification:15 cases of grade II and 16 cases of grade III.There were 14 males and 17 females in the study group,aged(46.91±5.36)years,NYHA cardiac function classification:12 cases of grade II and 19 cases of grade III.The control group was treated with cardiotonic,diuretic,β-blocker,aldosterone inhibitor,and sacubitril valsartan sodium,and the study group was treated with Qili Qiangxin capsules on the basis of the control group for 3 months.The clinical efficacy,left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume(LVEDV),left ventricular end-diastolic inner diameter(LVEDD),serum N-terminal pro-brain nitric peptide(NT-proBNP),laminin(LN),hyaluronic acid(HA),transforming growth factor-β1(TGF-β1),6 min walking distance(6MWD),and Generic Quality of Life Inventory-74(GQOLI-74)score before and after treatment,and incidence of adverse reactions during treatment were compared between the two groups.Independent sample t test,paired sample t test,andχ^(2) test were used.Results The total effective rate of the study group was 93.55%(29/31),higher than that of the control group[74.19%(23/31)](P<0.05).After treatment,the LVEF of the study group was higher than that of the control group[(47.11±5.68)%vs.(43.92±4.35)%],but the LVEDV and LVEDD were lower than those of the control group[(145.38±16.37)ml vs.(163.09±20.42)ml,(45.90±4.2

关 键 词：扩张型心肌病 沙库巴曲缬沙坦 芪苈强心胶囊 临床疗效 心肌纤维化 心室重构 

分 类 号：R542.2[医药卫生—心血管疾病]