袁超

摘要：目的  觀察沙库巴曲缬沙坦联合比索洛尔治疗慢性心力衰竭的效果。方法  选择我院2017年2月～2019年5月收治的慢性心力衰竭患者107例，随机分为对照组（55例）和观察组（52例）。对照组给予比索洛尔治疗，观察组给予沙库巴曲缬沙坦联合比索洛尔治疗，比较两组临床疗效、血清学指标[N端B型脑钠肽（NT-proBNP）、醛固酮（ALD）、细胞间黏附因子-1（ICAM-1）]、6 min步行距离、生活质量评分（明尼苏达量表，MLHFQ），记录两组不良反应的发生情况。结果  观察组治疗总有效率为96.15%，高于对照组的85.45%，差异有统计学意义（P<0.05）;治疗后两组NT-proBNP、ALD、ICAM-1水平均较治疗前降低，且观察组低于对照组，差异有统计学意义（P<0.05）;治疗后，观察组6 min步行距离、MLHFQ评分改善情况优于对照组，差异有统计学意义（P<0.05）;观察组不良反应发生率为11.54%，与对照组的12.73%比较，差异无统计学意义（P>0.05）。结论  沙库巴曲缬沙坦联合比索洛尔治疗慢性心力衰竭疗效较好，能有效改善患者血清指标水平、6 min步行距离及生活质量，具有一定的临床应用价值，且不增加不良反应。

关键词：慢性心力衰竭;沙库巴曲缬沙坦;比索洛尔

中图分类号：R541.6                                 文献标识码：A                                 DOI：10.3969/j.issn.1006-1959.2020.19.041

文章编号：1006-1959（2020）19-0135-03

Abstract：Objective  To observe the effect of sacubitril valsartan combined with bisoprolol in the treatment of chronic heart failure.Methods  A total of 107 patients with chronic heart failure admitted to our hospital from February 2017 to May 2019 were selected and randomly divided into control group （55 cases） and observation group （52 cases）. The control group was treated with bisoprolol， and the observation group was treated with sacubitrilvalsartan combined with bisoprolol. The clinical efficacy and serum indexes of the two groups were compared. [N-terminal B-type brain natriuretic peptide （NT-proBNP）， aldosterone （ALD）， intercellular adhesion factor-1 （ICAM-1）]， 6min walking distance， quality of life score （Minnesota scale， MLHFQ）， and record the occurrence of adverse reactions in the two groups.Results  The total effective rate of treatment in the observation group was 96.15%， which was higher than 85.45% in the control group，the difference was statistically significant （P<0.05）; the levels of NT-proBNP， ALD， and ICAM-1 in the two groups after treatment were lower than those before treatment， and the observation group was lower than the control group，the difference was statistically significant （P<0.05）; after treatment， the improvement of 6 min walking distance and MLHFQ score in the observation group was better than that of the control group，the difference was statistically significant （P<0.05）; The incidence of adverse reactions was 11.54%， which was not statistically significant compared with 12.73% in the control group （P>0.05）.Conclusion  The combination of sacubitril valsartan combined with bisoprolol had a good effect in the treatment of chronic heart failure. It could effectively improve the patient's serum index level， 6 min walking distance and quality of life. It had certain clinical application value and does not increase adverse reactions.

Key words：Chronic heart failure;Sacubatrilvalsartan;Bisoprolol

心肌梗死、血流动力学负荷过重、炎症等均会引起心肌损伤，导致患者心肌结构及功能异常，左室充盈及泵血功能低下，随着病情的进一步发展出现心力衰竭[1]。慢性心力衰竭（chronic heart failure，CHF）多由冠心病及扩张型心肌病导致，患者主要表现为呼吸困难、乏力及水肿等症状[2]。目前，临床治疗慢性心力衰竭从短期的血流动力学措施（利尿、强心、扩血管）转为以神经内分泌抑制剂为主的长期、修复性的策略。比索洛尔是一种高选择性的β受体拮抗剂，可缓解患者临床症状、改善预后、降低住院率和病死率，但是单一用药疗效欠佳，使用前需要遵医嘱接受ACE抑制剂、利尿剂和选择性使用强心苷类药物治疗[3]。……