摘要
目的研究左西孟旦联合沙库巴曲缬沙坦钠对老年急性失代偿性心力衰竭患者心功能、血清生长刺激表达基因2蛋白(sST2)、可溶性CD40配体(sCD40L)及预后的影响。方法选取2019年4月~2021年11月我院收治的150例老年急性失代偿性心力衰竭患者为研究对象,采用数字表法分为对照组和观察组,每组各75例。对照组采用沙库巴曲缬沙坦钠治疗,观察组采用左西孟旦联合沙库巴曲缬沙坦钠治疗。比较两组临床疗效、治疗前及治疗3个月后心功能指标[左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)]、血流动力学指标[心输出量(CO)、肺毛细血管楔压(PCWP)、肺动脉平均压(PAMP)、右房压(RAP)]、血清sST2、sCD40L、氨基末端B型利钠肽原(NT-pro BNP)、超敏C反应蛋白(hs-CRP)水平、治疗3个月后NYHA心功能分级。结果观察组临床总有效率为94.67%,高于对照组(82.67%),差异有统计学意义(χ^(2)=4.246、P<0.039)。治疗3个月后观察组LVEF高于对照组(t=9.052),LVEDD、LVESD低于对照组(t=5.184、8.152),差异均有统计学意义(P<0.05);CO高于对照组(t=5.306),PCWP、PAMP、RAP低于对照组(t=7.256、4.373、2.701),差异均有统计学意义(P<0.05);血清sST2、sCD40L、NT-pro BNP、hs-CRP水平低于对照组(t=10.525、7.451、9.857、8.776),差异均有统计学意义(P<0.05);NYHA心功能分级为Ⅰ级(41.33%)、Ⅱ级(50.67%)、Ⅲ级(5.33%)、Ⅳ级(2.67%),优于对照组(32.00%、41.33%、17.33%、9.33%),差异均有统计学意义(Z=2.076、P<0.019)。结论左西孟旦联合沙库巴曲缬沙坦钠治疗老年急性失代偿性心力衰竭患者可进一步提升疗效,改善心功能,调节血流动力学水平,缓解临床症状,促进病情恢复。
Objective To study the effect of levosimendan combined with sakubactrovalsartan sodium on cardiac function in elderly patients with acute decompensated heart failure、Growth STimulation Expressed Gene 2、sCD40L ELISA Kit and prognosis.Methods Taking 150 elderly patients with acute decompensated heart failure admitted to our hospital from April 2019 to November 2021 as the research object,they were divided into a control group and a combined group with 75 patients in each group by using the numerical table method.The control group was treated with sakubatrox valsartan sodium,and the combined group was treated with levosimendan and sakubatrox valsartan sodium.To compare the clinical efficacy,cardiac function indexes[Left Ventricular Ejection Fraction(LVEF),Left Ventricular End Diastolic Dimension(LVEDD),Left Ventricular End Systolic Dimension(LVESD)]Hemodynamic indexes[Cardiac Output(CO),Pulmonary Capillary Wedge Pressure(PCWP),Pulmonary Artery Mean Pressure(PAMP),Right Atrial Pressure(RAP)],serum sST2,sCD40L,N-terminal Pro-B-Type Natriuretic Peptide(NT pro BNP)Hypersensitive C-reactive protein(hs CRP)level,NYHA heart association grade after 3 months of treatment.Results The total clinical effective rate of the combined group was 94.67%higher than that of the control group(82.67%,the difference was statistically significant(χ^(2)=4.246、P<0.039);After 3 months of treatment,LVEF in the combination group was higher than that in the control group(t=9.052),LVEDD mm,LVESD mm were lower than that in the control group(t=5.184、8.152),the differences were statistically significant(P<0.05);After 3 months of treatment,CO index in combination group was higher than that in control group(t=5.306),PCWP,PAMP,RAP index was lower than that in control group(t=7.256、4.373、2.701),the differences were statistically significant(P<0.05);After 3 months of treatment,the levels of serum sST2,sCD40L,NT pro BNP,hs CRP in the combined group were lower than those in the control group(t=10.525、7.451、9.857、8.776),the differences we
作者
张岩
高辉
张玉
胡晓亮
吕素英
Zhang Yan;Gao Hui;Zhang Yu(Department of Internal Medicine-Cardiovascular,Shangqiu First People's Hospital,Shangqiu 476000,China)
出处
《华北理工大学学报（医学版）》
2023年第2期107-112,共6页
Journal of North China University of Science and Technology：Health Sciences Edition
