左西孟旦联合沙库巴曲缬沙坦钠治疗慢性心力衰竭的效果及对血流动力学的影响

熊建华

摘 要 目的：探討左西孟旦联合沙库巴曲缬沙坦钠治疗慢性心力衰竭的效果及对血流动力学的影响。方法：选择2019年1月—2021年1月江西省九江市德安县人民医院收治的慢性心力衰竭患者48例。按照随机数字表对照法分为两组，每组24例。对照组给予持续微量泵入左西孟旦注射液治疗，速率为0.5 mg·h-1，入院时1次，必要时1周后重复1次。观察组在对照组基础上联合使用沙库巴曲缬沙坦钠治疗，25～50 mg/次，2次/d。治疗1～4周。观察心功能、疗效、血清心肌损伤标志物水平。结果：观察组干预后心功能指标每搏心输出量（stroke volume，SV）和左心室射血分数（left ventricular ejection fraction，LVEF）水平均高于干预前以及对照组（P<0.05）。观察组总有效率为91.67%，高于对照组的70.83%（P<0.05）。观察组血清心肌损伤标志物N末端脑钠肽前体（N-terminal brain natriuretic peptide precursor，NT-proBNP）、肌钙蛋白T（Troponin T，cTnT）和肌钙蛋白I（Troponin I，cTnI）水平均低于干预前以及对照组（P<0.05），类胰岛素生长因子-1（Insulin-like growth factor-1，IGF-1）则高于干预前以及对照组（P<0.05）。结论：左西孟旦联合沙库巴曲缬沙坦钠治疗慢性心力衰竭效果较好，患者心功能、血清心肌损伤改善明显。

关键词 慢性心力衰竭；左西孟旦；沙库巴曲缬沙坦钠；效果；血流动力学；影响

中图分类号：R541.6 文献标志码：A 文章编号：1006-1533（2021）20-0016-04

Effect of levosimendan combined with sacubatro and valsartan sodium in the treatment of chronic heart failure and the influence on hemodynamics

XIONG Jianhua（Second Department of Internal Medicine of Peoples Hospital of Dean County， Jiujiang City， Jiangxi Province 330400， China）

ABSTRACT Objective： To investigate the effect of levosimendan combined with sacubatro and valsartan sodium in the treatment of chronic heart failure and the effect on hemodynamics. Methods： Forty-eight patients with chronic heart failure treated in Peoples Hospital of Dean County， Jiujiang City， Jiangxi Province from January 2019 to January 2021 were selected. According to the random number table control method， they were divided into two groups with 24 cases in each group. The control group was given continuous micro-pumping of levosimendan injection at a rate of 0.5 mg·h-1， once upon admission， and if necessary， repeated once a week later. On the basis of the control group， the observation group was treated with sacubatro and valsartan sodium， 25～50 mg/time， twice a day. Both groups were treated for 4 weeks. Cardiac function， curative effect， and serum levels of myocardial injury markers were observed. Results： The cardiac function indexes stroke volume and left ventricular ejection fraction levels of the observation group after intervention were higher than those before intervention and of the control group（P<0.05）. The total effective rate was 91.67% of the observation group， which was higher than 70.83% of the control group（P<0.05）. Serum cardiac markers N-terminal brain natriuretic peptide， troponin T and troponin I in serum of myocardial injury markers in the observation group were lower than those before the intervention and of the control group（P<0.05）， insulinlike growth factor-1 was higher than that before intervention and of the control group（P<0.05）. Conclusion： Levosimendan combined with sakubatro and valsartan sodium has a good effect in the treatment of chronic heart failure， and the cardiac function and serum markers of myocardial injury of the patients are improved significantly.