摘要
目的:探讨老年冠心病合并心力衰竭患者采用沙库巴曲缬沙坦钠片联合美托洛尔治疗的临床疗效.方法:选取2021 年 1 月—2023 年 1 月河南省开封市尉氏县中医院收治的 100 例冠心病合并心力衰竭的老年患者进行研究,采用交替分组法将患者分为 2 组,常规组(50 例)采用美托洛尔口服治疗,研究组(50 例)采用沙库巴曲缬沙坦钠片联合美托洛尔口服治疗.比较两组治疗疗效、心功能[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)]、心肌酶谱水平[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)]及肌酐(Scr)、尿素氮(BUN)、B型钠尿肽(BNP)水平,另比较两组不良反应发生率.结果:研究组临床有效率高于常规组(P<0.05);研究组LVEF水平较高,LVEDD、LVESD水平、CK、CK-MB、LDH、BNP水平低于常规组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05).结论:沙库巴曲缬沙坦钠片联合美托洛尔能有效提高冠心病合并心力衰竭患者的临床疗效,改善患者的心功能,减轻肾脏负担,且安全性高.
Abstract
Objective:To investigate the clinical efficacy of sacubitril valsartan sodium tablets combined with metoprolol in the treatment of elderly patients with coronary heart disease and heart failure.Methods:From January 2021 to January 2023,100 elderly patients with coronary heart disease and heart failure admitted to Weishi County Hospital of Traditional Chinese Medicine in Kaifeng City,Henan Province were selected for study.The patients were divided into two groups by alternating grouping method.The conventional group(50 patients)was treated with metoprolol orally,and the study group(50 patients)was treated with sacubitril valsartan sodium tablets combined with metoprolol orally.The therapeutic effect,cardiac function[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)],myocardial enzyme spectrum levels[creatine kinase(CK),creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH)]and creatinine(Scr),urea nitrogen(BUN),B-type natriuretic peptide(BNP)levels were compared between the two groups,and the incidence of adverse reactions was compared between the two groups.Results:The clinical effective rate of the study group was higher than that of the conventional group(P<0.05).The level of LVEF in the study group was higher,and the levels of LVEDD,LVESD,CK,CK-MB,LDH and BNP were lower than those in the conventional group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Sacubactril valsartan sodium tablets combined with metoprolol can effectively improve the clinical efficacy of patients with coronary heart disease complicated with heart failure,improve the heart function,reduce the burden of kidney,and have higher safety.
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