沙库巴曲缬沙坦联合比索洛尔对冠心病合并慢性心力衰竭患者心功能、血清炎性因子及临床疗效的影响

Effects of Sacubitril/Valsartan Combined with Bisoprolol on Cardiac Function, Serum Inflammatory Factors, and Clinical Efficacy in Patients with Coronary Heart Disease Complicated by Chronic Heart Failure

摘要

目的 探究沙库巴曲缬沙坦联合比索洛尔治疗冠心病（coronary heart disease，CHD）合并慢性心力衰竭（chronic heart failure，CHF）患者对血清炎性因子[超敏C反应蛋白（high-sensitivity C reactive protein, hs-CRP）、白细胞介素-6（interleukin-6，IL-6）、肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）]和心功能等指标的影响。方法 选取2022年2月至2024年2月树兰（衢州）医院心血管内科收治的160例纽约心脏病协会心功能分级为Ⅱ~Ⅲ级的CHD合并CHF患者，采用随机数字表法分为对照组和观察组，各80例。对照组给予比索洛尔治疗，观察组实施沙库巴曲缬沙坦联合比索洛尔治疗，2组疗程均为3个月，并随访至6个月，比较2组临床疗效和血清炎性因子及心功能指标等差异。结果 观察组治疗总有效率为90.00%，高于对照组的75.00%（P< 0.05）。治疗3个月后及随访至6个月时，观察组左心室射血分数、心排血量均较对照组升高，左心室收缩末内径较对照组缩短（ P< 0.05）；观察组TNF-α、IL-6、hs-CRP、N末端B型利钠肽原、血浆黏度、全血黏度及红细胞比容均较对照组降低（ P< 0.05）。结论 沙库巴曲缬沙坦联合比索洛尔治疗CHD合并CHF不仅能显著提升临床疗效，还能有效降低血清炎性因子水平，改善患者心功能。

Abstract

Objective To explore the effects of sacubitril/valsartan combined with bisoprolol on serum inflammatory factors [high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α)] and cardiac function in patients with coronary heart disease (CHD) complicated by chronic heart failure (CHF).Methods A total of 160 patients with CHD and CHF, classified as New York Heart Association functional class II – III, admitted to the Department of Cardiology of Shulan (Quzhou) Hospital from February 2022 to February 2024 were selected. They were divided into two groups using a random number table method, with 80 patients in each group. The control group was administered bisoprolol, while the intervention group received sacubitril/valsartan combined with bisoprolol. The treatment course lasted 3 months in both groups, with follow-up conducted up to 6 months. The differences in clinical efficacy, serum inflammatory factors, and cardiac function indices were compared between the two groups.Results The total effective rate of the intervention group was 90.00%, which was higher than the 75.00% in the control group (P< 0.05). At 3 months post-treatment and at the 6-month follow-up, the left ventricular ejection fraction and cardiac output in the intervention group were significantly higher than those in the control group, while the left ventricular end-systolic diameter was shorter ( P< 0.05). The levels of TNF-α, IL-6, hs-CRP, N-terminal pro-B-type natriuretic peptide, plasma viscosity, whole blood viscosity, and hematocrit in the intervention group were also significantly lower than those in the control group ( P< 0.05). Conclusion Sacubitril/valsartan combined with bisoprolol in the treatment of CHD complicated by CHF can not only markedly improve clinical efficacy, but also effectively reduce serum inflammatory factor levels and enhance cardiac function.

关键词

沙库巴曲缬沙坦 / 比索洛尔 / 冠心病 / 慢性心力衰竭 / 心功能指标 / 血清炎性因子

Key words

sacubitril/valsartan / bisoprolol / coronary heart disease / chronic heart failure / cardiac function index / serum inflammatory factor

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