沙库巴曲缬沙坦联合美托洛尔治疗老年慢性心功能不全的临床效果

目的:研究沙库巴曲缬沙坦联合美托洛尔治疗老年慢性心功能不全的临床效果及安全性。方法:选择2018年1月～2019年1月我院收治的82例老年慢性心功能不全患者并将其随机分为两组。对照组患者在常规治疗的基础上口服美托洛尔治疗,每次25 mg,每天2次;观察组在对照组的基础上联合口服沙库巴曲缬沙坦,初始的给药剂量为每次50 mg,每天2次,然后每2周增加50 mg,最高给药剂量为每次200 mg。比较两组治疗前后的左室射血分数(LVEF)、生存质量表(KCCQ)评分、6 min步行距离、血清细胞间黏附分子-1(ICAM-1)、N端B型脑钠肽(NT-pro BNP)以及醛固酮(ALD)水平的变化及治疗期间不良反应的发生情况。结果:治疗后,观察组的有效率明显高于对照组(90.24%vs. 73.17%,P0.05);两组的LVEF、6 min步行距离和KCCQ评分均较治疗前明显升高,血清ICAM-1、NT-pro BNP以及ALD水平均较治疗前明显降低,且上述指标观察组变化更显著(均P0.05)。两组治疗期间心动过缓,头晕、头痛,高钾血症,低血压和肝肾功能异常的发生率比较差异无明显统计学意义(P0.05)。结论:与单用美托洛尔治疗相比,沙库巴曲缬沙坦联合美托洛尔能更有效改善老年慢性心功能不全患者的心功能及生活质量,且安全性较高。

Clinical Efficacy of Sakubatril Valsartan Combined with Metoprolol in the Treatment of Elderly Patients with Chronic Cardiac Insufficiency

ABSTRACT Objective: To study the clinical effect and safety of sakubatril valsartan combined with metoprolol in the treatment of elderly patients with chronic cardiac insufficiency. Methods: 82 elderly patients with chronic cardiac insufficiency who were treated in our hospital from January 2018 to January 2019 were randomly divided into two groups. The control group was treated with metoprolol only, 25 mg each time, twice a day. The observation group was with oral shakuba valsartan on the basis of the control group, the initial dosage was 50 mg each time, twice a day, and then increased by 50 mg every two weeks, the highest dosage was 200 mg each time. The changes of LVEF, KCCQ score and 6-minute walking distance, ICAM-1, NT-pro BNP and ALD before and after treatment, and the occurrence of adverse reactions during treatment were compared between the two group. Results: After treatment, the effective rate of observation group was significantly higher than that of the control group (90.24% vs. 73.17%, P<0.05), the LVEF, 6-minute walking distance and KCCQ scores of the two groups were significantly higher, and the serum ICAM-1, NT-pro BNP and ALD levels were significantly lower, the above index in the observation group improved better than those of te control group(both P<0.05). There was no significant difference in the incidence of bradycardia, dizziness, headache, hyperkalemia, hypotension and hepatorenal dysfunction during the two groups(P>0.05). Conclusion: Compared with metoprolol alone, sirolimus combined with metoprolol is more effective and safe in improving the cardiac function and the quality of life in elderly patients with chronic cardiac insufficiency.