摘要
目的:观察美托洛尔联合沙库巴曲缬沙坦治疗冠心病合并慢性心力衰竭的效果,并探究其对患者血管炎症反应、心肌重塑及血管内皮功能的影响。方法:选取2018年1月—2022年12月上饶市人民医院收治的80例冠心病合并慢性心力衰竭患者,应用随机数字表法进行分组,分为常规组与联合组,每组40例。常规组采用美托洛尔治疗,联合组治疗在常规组基础上加用沙库巴曲缬沙坦。比较两组临床治疗效果、血清检测指标[血清可溶性CD40配体(sCD40L)、血浆脂肪因子趋化素(Chemerin)及血清超敏C反应蛋白(hs-CRP)水平]、心肌重塑指标[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)]、血管内皮功能指标[血浆内皮素(ET)、降钙素基因相关肽(CGRP)水平及血浆一氧化氮(NO)水平]、不良反应的发生情况。结果:治疗后,联合组总有效率显著高于常规组(P<0.05)。治疗前,两组的sCD40L、Chemerin及hs-CRP水平相比,差异均无统计学意义(P>0.05);治疗后,两组的s CD40L、Chemerin及hs-CRP水平与治疗前相比均下降,且联合组均显著低于常规组,差异均有统计学意义(P<0.05)。治疗前,两组LVEF、LVEDD及LVESD比较,差异均无统计学意义(P>0.05);治疗后,联合组LVEF显著高于常规组,LVEDD与LVESD均显著小于常规组,差异均有统计学意义(P<0.05)。治疗前,两组ET、CGRP及NO水平比较,差异均无统计学意义(P>0.05);治疗后,联合组ET水平显著低于常规组,CGRP及NO水平均显著高于常规组,差异均有统计学意义(P<0.05)。两组不良反应发生率,差异无统计学意义(P>0.05)。结论:联合应用沙库巴曲缬沙坦与美托洛尔治疗冠心病伴慢性心力衰竭的疗效显著,可改善患者的心功能,减轻血管炎症反应,逆转心肌重塑,纠正血管内皮功能,安全性较高。
Objective:To observe the efficacy of Metoprolol combined with Sacubitril Valsartan in the treatment of coronary heart disease with chronic heart failure,and to explore the effects on vascular inflammatory response,myocardial remodeling and vascular endothelial function of patients.Method:A total of 80 patients with coronary heart disease complicated with chronic heart failure admitted to Shangrao People's Hospital from January 2018 to December 2022 were selected,and divided into a conventional group and a combined group by random number table method,with 40 cases in each group.The conventional group was treated with Metoprolol,and the combined group was additionally given Sacubitril Valsartan on the basis of the conventional group.The clinical therapeutic effect,serum detection indicators[serum soluble CD40 ligand(sCD40L),plasma adipokine chemokine(Chemerin),serum hypersensitive C reactive protein(hs-CRP)],myocardial remodeling indicators[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)]and vascular endothelial function indicators[plasma endothelin(ET),calcitonin gene-related peptide(CGRP),plasma nitric oxide(NO)]and occurrence of adverse reactions were compared between the two groups.Result:After treatment,the total effective rate in combined group was significantly higher than that in conventional group(P<0.05).Before treatment,there were no statistical differences in the levels of sCD40L,Chemerin and hs-CRP between the two groups(P>0.05);after treatment,the sCD40L,Chemerin and hs-CRP levels in two groups were decreased compared with those before treatment,and those in combined group were significantly lower than those in conventional group,the differences were statistically significant(P<0.05).Before treatment,the LVEF,LVEDD and LVESD showed no statistical differences between the two groups(P>0.05);after treatment,the LVEF in combined group was significantly higher than that in conventional group while the LVEDD and LVESD were
作者
张元亚
郑文
张上仕
廖玲
ZHANG Yuanya;ZHENG Wen;ZHANG Shangshi;LIAO Ling(General Medicine Department,Shangrao People's Hospital,Shangrao 334000,China;不详)
出处
《中国医学创新》
CAS
2024年第1期47-53,共7页
Medical Innovation of China
