沙库巴曲缬沙坦联合美托洛尔治疗高龄难治性心力衰竭的效果  

Effect of Sacubitril Valsartan Combined with Metoprolol in the Treatment of Elderly Patients with Refractory Heart Failure

作　　者：李艳丽 李辉芳 曹瑞娜 霍飞蛟 LI Yanli;LI Huifang;CAO Ruina;HUO Feijiao(Department of Cardiovascular Medicine,Gongyi People's Hospital of Henan Province,Zhengzhou 451200,Henan,China)

机构地区：[1]河南省巩义市人民医院心血管内科,河南郑州451200

出　　处：《中国药物滥用防治杂志》2025年第2期311-314,共4页Chinese Journal of Drug Abuse Prevention and Treatment

摘　　要：目的:探讨沙库巴曲缬沙坦联合美托洛尔治疗高龄难治性心力衰竭的疗效及对其心功能、心室重构的影响。方法:选取我院2019年4月—2022年4月接收的92例高龄难治性心力衰竭患者,以随机数字表分为对照组和联合组,各46例。对照组采用常规干预及美托洛尔治疗,联合组在对照组基础上联用沙库巴曲缬沙坦治疗。比较两组临床疗效、心功能[心输出量(CO)、心脏指数(CI)、每搏输出量(SV)、左室射血分数(LVEF)、血清N末端脑钠肽前体(NT-proBNP)]、心室重构指标[舒张末期室间隔厚度(IVST)、左室舒张末期后壁厚度(LVPWT)、左室舒张末期内径(LVEDD)、左室质量指数(LVMI)、左室收缩末期内径(LVESD)]及用药安全性。结果:联合组总有效率高于对照组(P<0.05);联合组NT-proBNP水平低于对照组,CO、CI、SV、LVEF高于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:采用沙库巴曲缬沙坦联合美托洛尔治疗能有效改善高龄难治性心力衰竭患者心功能、减轻心室重构,且疗效显著、安全性高。Objective:To investigate the efficacy of sacubitril valsartan combined with metoprolol in the treatment of elderly patients with refractory heart failure and its effect on cardiac function and ventricular remodeling.Methods:A total of 92 elderly patients with refractory heart failure received in our hospital from April 2019 to April 2022 were selected and divided into control group and combined group by random number table,with 46 cases in each group.The control group was treated with routine intervention and metoprolol,and the combined group was treated with sacubitril valsartan on the basis of the control group.The clinical efficacy,cardiac function[cardiac output(CO),cardiac index(CI),stroke volume(SV),left ventricular ejection fraction(LVEF),serum N-terminal pro-brain natriuretic peptide(NT-proBNP)],ventricular remodeling index[end-diastolic interventricular septal thickness(IVST),left ventricular end-diastolic posterior wall thickness(LVPWT),left ventricular end-diastolic diameter(LVEDD),left ventricular mass index(LVMI),left ventricular endsystolic diameter(LVESD)]and medication safety were compared between the two groups.Results:The total effective rate of the combined group was higher than that of the control group(P<0.05).The level of NT-proBNP in the combined group was lower than that in the control group,and CO,CI,SV and LVEF were higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The treatment of sacubitril valsartan combined with metoprolol can effectively improve cardiac function and reduce ventricular remodeling in elderly patients with refractory heart failure,and the curative effect is significant and safe.

关 键 词：沙库巴曲缬沙坦 美托洛尔 难治性心力衰竭 临床疗效 心功能 心室重构 

分 类 号：R541.6[医药卫生—心血管疾病]