熊建華

摘 要 目的：探討左西孟旦聯(lián)合沙庫(kù)巴曲纈沙坦鈉治療慢性心力衰竭的效果及對(duì)血流動(dòng)力學(xué)的影響。方法：選擇2019年1月—2021年1月江西省九江市德安縣人民醫(yī)院收治的慢性心力衰竭患者48例。按照隨機(jī)數(shù)字表對(duì)照法分為兩組，每組24例。對(duì)照組給予持續(xù)微量泵入左西孟旦注射液治療，速率為0.5 mg·h-1，入院時(shí)1次，必要時(shí)1周后重復(fù)1次。觀察組在對(duì)照組基礎(chǔ)上聯(lián)合使用沙庫(kù)巴曲纈沙坦鈉治療，25～50 mg/次，2次/d。治療1～4周。觀察心功能、療效、血清心肌損傷標(biāo)志物水平。結(jié)果：觀察組干預(yù)后心功能指標(biāo)每搏心輸出量（stroke volume，SV）和左心室射血分?jǐn)?shù)（left ventricular ejection fraction，LVEF）水平均高于干預(yù)前以及對(duì)照組（P<0.05）。觀察組總有效率為91.67%，高于對(duì)照組的70.83%（P<0.05）。觀察組血清心肌損傷標(biāo)志物N末端腦鈉肽前體（N-terminal brain natriuretic peptide precursor，NT-proBNP）、肌鈣蛋白T（Troponin T，cTnT）和肌鈣蛋白I（Troponin I，cTnI）水平均低于干預(yù)前以及對(duì)照組（P<0.05），類胰島素生長(zhǎng)因子-1（Insulin-like growth factor-1，IGF-1）則高于干預(yù)前以及對(duì)照組（P<0.05）。結(jié)論：左西孟旦聯(lián)合沙庫(kù)巴曲纈沙坦鈉治療慢性心力衰竭效果較好，患者心功能、血清心肌損傷改善明顯。

關(guān)鍵詞 慢性心力衰竭；左西孟旦；沙庫(kù)巴曲纈沙坦鈉；效果；血流動(dòng)力學(xué)；影響

中圖分類號(hào)：R541.6 文獻(xiàn)標(biāo)志碼：A 文章編號(hào)：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.