恩格列净联合沙库巴曲缬沙坦治疗冠心病合并HFmrEF的疗效及对心脏结构、心功能及炎症因子的影响  

Effect of engliglizin combined with sacubactril valsartan in the treatment of coronary heart disease combined with HFmrEF and its effects on cardiac structure,function and inflammatory factors

作　　者：别海浩 齐勤学 马新柱 王宪沛 BIE Hai-hao;QI Qin-xue;MA Xin-zhu;WANG Xian-pei(Department of Cardiovascular,Nanyang Yuxi Jianhe Hospital,Nanyang 474599,Henan,CHINA)

机构地区：[1]南阳豫西健和医院心血管内科,河南南阳474599

出　　处：《海南医学》2025年第8期1082-1086,共5页Hainan Medical Journal

基　　金：河南省卫生健康委员会、河南省医学科技攻关计划省部共建项目(编号:SBGJ2018082)。

摘　　要：目的观察恩格列净联合沙库巴曲缬沙坦治疗冠心病合并射血分数中间值心力衰竭(HFmrEF)的疗效,并探讨其对患者心脏结构、心功能及炎症因子的影响。方法选择2021年3月至2024年1月南阳豫西健和医院收治的100例冠心病合并HFmrEF患者作为研究对象,按随机数表法分为观察组和对照组各50例。对照组患者在常规治疗基础上应用沙库巴曲缬沙坦钠片治疗,观察组患者在对照组治疗的基础上联合恩格列净治疗,两组均持续治疗3个月。比较两组患者治疗前、治疗3个月后的左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左心房内径(LAD)、左室射血分数(LVEF)、N末端B型脑钠肽前体(NT-proBNP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和正五聚蛋白-3(PTX-3)水平,并比较两组患者治疗期间的不良反应发生率及随访6个月的不良心血管事件(MACE)发生率。结果治疗后,观察组患者的LVEDD、LVESD、LAD分别为(49.45±3.28)mm、(42.53±3.67)mm、(38.04±3.42)mm,明显低于对照组的(51.68±3.45)mm、(44.19±3.05)mm、(40.11±2.72)mm,差异均有统计学意义(P<0.05);治疗后,观察组患者的LVEF为(48.65±4.28)%,明显高于对照组的(46.39±3.64)%,NT-proBNP为(1732.93±215.60)ng/L,明显低于对照组的(1977.25±267.41)ng/L,差异均有统计学意义(P<0.05);治疗后,观察组患者的血清TNF-α、IL-6、PTX-3水平分别为(211.34±25.63)ng/L、(6.58±1.47)ng/L、(3.11±0.63)μg/L,明显低于对照组的(256.17±33.49)ng/L、(8.94±1.65)ng/L、(3.97±0.58)μg/L,差异均有统计学意义(P<0.05);观察组患者治疗期间的不良反应总发生率为16.00%,略高于对照组的12.00%,但差异无统计学意义(P>0.05);随访6个月,观察组患者失访2例,对照组失访1例,观察组患者MACE发生率为4.17%,略低于对照组的12.24%,但差异无统计学意义(P>0.05)。结论恩格列净联合沙库巴曲缬沙坦治疗有助于改善冠心病合并HFmrEF患者的心脏结构、心Objective To observe the efficacy of englaglizin combined with sackubatrotril valsartan in the treatment of coronary heart disease with heart failure with median ejection fraction(HFmrEF),and to explore the effects of englaglizin on cardiac structure,cardiac function and inflammatory factors.Methods A total of 100 patients with coronary heart disease combined with HFmrEF admitted to Nanyang Yuxi Jianhe Hospital from March 2021 to Janu-ary 2024 were selected as the subjects of this study,and they were divided into an observation group and a control group(50 cases in each group)according to random number table method.Patients in the control group were treated with sacubactril valsartan sodium tablets on the basis of conventional treatment,and those in the observation group were treated with englaglizin on the basis of control group,for 3 months.The left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left atrial diameter(LAD),left ventricular ejection fraction(LVEF),N-terminal B-type brain natriuretic peptide precursor(NT-proBNP),tumor necrosis factor-α(TNF-α)and in-terleukin-6(IL-6)at before treatment and 3 months after treatment were compared between the two groups patients,and the incidence of adverse reactions during treatment and the incidence of adverse cardiovascular events(MACE)at 6 months follow-up were compared between the two groups.Results After treatment,LVEDD,LVESD and LAD in the observation group were(49.45±3.28)mm,(42.53±3.67)mm,(38.04±3.42)mm,which were significantly lower than(51.68±3.45)mm,(44.19±3.05)mm,and(40.11±2.72)mm of control group(P<0.05);after treatment,the LVEF in the observation group was(48.65±4.28)%,which was significantly higher than(46.39±3.64)%in the control group,and the NT-proBNP was(1732.93±215.60)ng/L,which was significantly lower than(1977.25±267.41)ng/L in the control group(P<0.05);after treatment,the serum levels of TNF-α,IL-6 and PTX-3 in the observation group were(211.34±25.63)ng/L,(6.58±1.47)ng/L,(3.11±0.63)μg/L,wh

关 键 词：冠心病 射血分数中间值心力衰竭 沙库巴曲缬沙坦 恩格列净 心功能 炎症因子 

分 类 号：R541.4[医药卫生—心血管疾病]