沙库巴曲缬沙坦钠联合左西孟旦对瓣膜病心衰患者的临床疗效及心功能影响

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摘要 目的: 研究探讨沙库巴曲缬沙坦钠联合左西孟旦对瓣膜病心衰患者的临床疗效及心功能影响。方法: 选取2019年10月—2022年10月本院收治的150例瓣膜病心衰患者,分为观察组、对照组,每组75例。对照组以常规治疗,观察组以沙库巴曲缬沙坦钠联合左西孟旦治疗。3个疗程后评估两组临床疗效、心功能、血管内皮功能、心肌损伤指标及治疗安全性。结果: 观察组中途退出1例、调整治疗方案2例,对照组中途退出2例、观察指标结果缺失1例,均剔除本研究。观察组总有效率为91.67%（66/72）,高于对照组患者为77.78%（56/72）。治疗后,观察组左室射血分数（LVEF）、心输出量（CO）均高于对照组,而左心室舒张末期内径（LVEDD）、左心室舒张末期容积（LVEDV）均低于对照组。治疗后,观察组血管内皮素-1（ET-1）、血管紧张素-II（Ang-II）水平低于对照组,一氧化氮（NO）高于对照组。治疗后,观察组心型脂肪酸结合蛋白（H-FABP）、肌红蛋白（MYO）、细胞外基质金属蛋白酶诱导因子（EMMPRIN）水平均低于对照组。治疗期间两组不良反应发生率分别为11.11%（8/72）、8.33%（6/72）。结论: 沙库巴曲缬沙坦钠联合左西孟旦对瓣膜病心衰患者的临床疗效显著,可改善患者的心功能和血管内皮功能,降低心肌细胞损伤标志物水平,治疗安全性良好。

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	高俊杰
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关键词 ：瓣膜病心衰, 左西孟旦, 沙库巴曲缬沙坦钠, 临床疗效, 心功能

Abstract：Objective To investigate the clinical efficacy and cardiac function of nohintal (sacubactril valsartan sodium) combined with levosimendan in patients with valvular heart failure. Methods 150 patients with valvular heart failure admitted to our hospital from October 2019 to October 2022 were selected as research objects, and were divided into observation group and control group by random number table method, with 75 cases in each group. The control group was treated with levosimendan, and the observation group was treated with nocinol combined with levosimendan. After 3 courses of treatment, the clinical efficacy, cardiac function, vascular endothelial function, myocardial injury markers and therapeutic safety of the two groups were evaluated. Results 1 case of voluntary withdrawal in the observation group, 2 cases of adjustment of treatment plan, 2 cases of voluntary withdrawal in the control group, and 1 case of missing observation index results were excluded from this study. The total effective rate of observation group was 91.67% (66/72), which was higher than that of control group 77.78% (56/72) (P<0.05). After treatment, left ventricular ejection fraction (LVEF) and cardiac output (CO) in observation group were higher than those in control group, but left ventricular end-diastolic diameter (LVEDD) and left ventricular end-diastolic volume (LVEDV) in observation group were lower than those in control group. After treatment, the levels of angioendothelin-1(ET-1) and angiotensin-II (Ang-II) in observation group were lower than those in control group, and the levels of nitric oxide (NO) were higher than those in control group. After treatment, the levels of cardiac fatty acid-binding protein (H-FABP), myoglobin (MYO) and extracellular matrix metalloproteinase-inducing factor (EMMPRIN) in observation group were lower than those in control group. The incidence of adverse reactions in the two groups was 11.11% (8/72) and 8.33% (6/72), respectively, and there was no significant difference between the two groups. Conclusion Nohintal combined with levosimendan has significant clinical efficacy in patients with valvular heart failure, which can improve the cardiac function and vascular endothelial function, reduce the level of myocardial cell injury markers, and has good therapeutic safety.

Key words： valvular disease heart failure levosimendan sacubactril sodium valsartan heart function vascular endothelial function markers of myocardial injury

收稿日期: 2024-03-27

基金资助:河北省医学科学研究课题“不同剂量替格瑞洛治疗急性冠脉综合征(非血运重建心绞痛)者的疗效、安全性及成本-效益分析”（20201314）; 秦皇岛市科学技术研发与发展计划自筹经费项目“诺欣妥联合达格列净在心力衰竭合并糖尿病患者中的应用研究”（202301A048）

通讯作者: 汤秀英,E-mail：13472996700@163.com

引用本文:

高俊杰, 李润军, 张丽芳, 汤秀英. 沙库巴曲缬沙坦钠联合左西孟旦对瓣膜病心衰患者的临床疗效及心功能影响[J]. 湖南师范大学学报(医学版), 2024, 21(4): 41-44. GAO Junjie, LI Runjun, ZHANG Lifang, TANG Xiuying. Clinical efficacy and cardiac function of Sacubactril sodium valsartan combined with levosimendan in patients with valvular heart failure. HuNan ShiFan DaXue XueBao(YiXueBan), 2024, 21(4): 41-44.

链接本文:

http://yxb.hunnu.edu.cn/CN/ 或 http://yxb.hunnu.edu.cn/CN/Y2024/V21/I4/41

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