首页|沙库巴曲缬沙坦联合美托洛尔对慢性心功能不全患者的疗效及对CXCL13、SERCA2a水平的影响

沙库巴曲缬沙坦联合美托洛尔对慢性心功能不全患者的疗效及对CXCL13、SERCA2a水平的影响

Therapeutic effect of sacubitril valsartan combined metoprolol on patients with chronic cardiac insuffi-ciency and its impact on CXCL13 and SERCA2a levels

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目的:探讨沙库巴曲缬沙坦联合美托洛尔对慢性心功能不全患者的治疗效果及对趋化因子CXC配体13(CXCL13)、人心肌肌浆网钙离子ATP酶2a(SERCA2a)水平的影响.方法:选择2018年6月~2021年12月北京大学深圳医院收治的120例慢性心功能不全患者,采用随机数字表法分为对照组、联合治疗组,各60例.对照组以美托洛尔治疗,联合治疗组在对照组的基础上增加沙库巴曲缬沙坦治疗.治疗90d后对比两组患者的临床疗效、心功能、冠脉血流动力学、CXCL13、SERCA2a水平及治疗安全性.结果:联合治疗组总有效率为91.67%(55/60),显著高于对照组的76.67%(46/60)(P=0.024).治疗后,与对照组比较,联合治疗组左室射血分数(LVEF)、心输出量(CO)、冠脉舒张期血流峰值速度(DPV)、收缩期血流峰值速度(SPV)、舒张期流速时间积分(DVTI)、收缩期流速时间积分(SVTI)和SERCA2a水平均显著升高,左室舒张末期容积(LVEDV)、左室舒张末期内径(LVEDd)显著减小,CXCL13水平显著降低(P均<0.001).治疗期间两组患者不良反应发生率无显著性差异(P=0.378).结论:沙库巴曲缬沙坦联合美托洛尔对慢性心功能不全患者效果良好,可改善患者心功能水平,增加患者的冠脉血流速度,降低CXCL13水平、提高SERCA2a水平,治疗安全性良好.
Objective:To study the therapeutic effect of sacubitril valsartan combined metoprolol on patients with chronic cardiac insufficiency and its impact on levels of chemokine CXC ligand 13(CXCL13)and human cardiac sarcoplasmic reticulum calcium ion ATPase 2a(SERCA2a).Methods:This randomized controlled study enrolled 120 patients with chronic cardiac insufficiency admitted in Peking University Shenzhen Hospital between June 2018 and December 2021.They were divided into control group(n=60,metoprolol therapy)and combined treatment group(n=60,additional sacubitril valsartan therapy based on control group).After 90d treatment,therapeutic effect,cardiac function,coronary hemodynamics,levels of CXCL13 and SERCA2a,and safety were compared between two groups.Results:Total effective rate in combined treatment group was significantly higher than that of control group(91.67%vs.76.67%,P=0.024).Compared with patients in control group after treatment,those in combined treatment group had significant higher left ventricular ejection fraction(LVEF),cardiac output(CO),coronary diastolic peak veloci-ty(DPV),systolic peak velocity(SPV),diastolic velocity time integral(DVTI),systolic velocity time integral(SVTI)and SERCA2a level,and significant lower left ventricular end-diastolic volume(LVEDV),left ventricular end-diastolic di-ameter(LVEDd)and CXCL13 level(P<0.001 all).We detected no significant difference in incidence of adverse reac-tions between two groups during treatment(P=0.378).Conclusion:Sacubitril valsartan combined with metoprolol has good therapeutic effect in patients with chronic cardiac insufficiency.It can improve cardiac function,increase the coronary blood flow velocity,reduce CXCL13 level and increase SERCA2a level with good safety.

Heart FailureMetoprololSacubitril valsartan

杨海涛、王冠、邱良贤、李秋荣

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北京大学深圳医院心内科,广东 深圳 518000

心力衰竭 美托洛尔 沙库巴曲缬沙坦

2024

心血管康复医学杂志
福建省康复医学会 中国康复医学会

心血管康复医学杂志

CSTPCD
影响因子:1.157
ISSN:1008-0074
年,卷(期):2024.33(6)