目的 探討沙庫巴曲纈沙坦鈉聯(lián)合硝酸甘油治療老年慢性心力衰竭的臨床療效。方法 選擇2021年2月—2022年2月在阜外華中心血管病醫(yī)院接受治療的94例老年慢性心力衰竭患者，根據(jù)入院順序分為對照組（47例）和治療組（47例）。對照組靜脈泵入硝酸甘油注射液，每次10 mg加入生理鹽水50mL，5～8mL/h速度持續(xù)靜脈泵入，1次/d；治療組在對照組基礎(chǔ)上口服沙庫巴曲纈沙坦鈉片，100mg/次，2次/d。兩組患者均治療2周。觀察兩組患者臨床療效，比較治療前后兩組患者臨床癥狀改善時間，MLHFQ評分、Lee氏心衰積分和SCHFI評分，血清正五聚體蛋白-3（PTX-3）、可溶性腫瘤發(fā)生抑制蛋白2（sST2）、N末端B型鈉尿肽原（NT-proBNP）、可溶性尿激酶型纖溶酶原激活物受體（suPAR）和中心臟型肌球蛋白結(jié)合蛋白-C（cMyBP-C）水平及心功能指標(biāo)左心室射血分數(shù)（LVEF）、心臟指數(shù)（CI）、左室質(zhì)量指數(shù)（LVMI）、心排血量（CO）和室間隔厚度（IVSd）。結(jié)果 治療后，對照組患者總有效率為80.85%，明顯低于治療組（97.87%，P<0.05）。經(jīng)治療，治療組臨床癥狀改善時間均明顯早于對照組（P<0.05）。治療后，兩組MLHFQ評分和Lee氏心衰積分明顯降低，而SCHFI評分明顯升高（P<0.05），且治療組評分明顯好于對照組（P<0.05）。治療后，兩組血清PTX-3、sST2、NT-proBNP、suPAR、cMyBP-C水平明顯降低（P<0.05），且治療組明顯低于對照組（P<0.05）。治療后，兩組LVEF、CI和CO水平明顯升高，而LVMI、IVSd水平明顯降低（P<0.05），且治療組心功能明顯好于對照組（P<0.05）。結(jié)論 沙庫巴曲纈沙坦鈉聯(lián)合硝酸甘油治療老年慢性心力衰竭臨床效果顯著，可有效改善患者癥狀，提高患者心功能，抑制心室重構(gòu)，不僅可改善生活質(zhì)量，還促進改善自我護理能力。

Objective To investigate the clinical efficacy of sacubitril valsartan sodium combined with nitroglycerin in treatment of senile chronic heart failure. Methods Patients (94 cases) with chronic heart failure in Fuwai Central China Cardiovascular Hospital from February 2021 to February 2022 were divided into control (47 cases) and treatment (47 cases) group based on hospitalized order. Patients in the control group were iv administered with Nitroglycerin Injection, 10 mg added into normal saline 50 mL, continuous intravenous pumping at the speed of 5 — 8 mL/h, once daily. Patients in the treatment group were po administered with Sacubitril Valsartan Sodium Tablets on the basis of the control group, 100 mg/time, twice daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical evaluation was evaluated, the improvement time of clinical symptoms, the scores of MLHFQ, Lee’s heart failure and SCHFI, the levels of serum PTX-3, sST2, NT-proBNP, suPAR, and cMyBP-C, the levels of cardiac function indexes LVEF, CI, CO, LVMI, and IVSd in two groups before and after treatment were compared. Results After treatment, the total clinical effective rate of the control group was 80.85%, which was significantly lower than that of the treatment group (97.87%, P < 0.05). After treatment, the improvement time of clinical symptoms in the treatment group was significantly earlier than that in the control group (P< 0.05). After treatment, the MLHFQ score and Lee's heart failure score were significantly decreased, while the SCHFI score was significantly increased in two groups (P < 0.05), and these scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the serum levels of PTX-3, sST2, NT-proBNP, suPAR, and cMyBP-C in two groups were significantly decreased (P < 0.05), which in the treatment group were significantly lower than those in the control group (P< 0.05). After treatment, the levels of LVEF, CI, and CO in two groups were significantly increased, while the levels of LVMI and IVSd were significantly decreased (P < 0.05), and the cardiac function in the treatment group was significantly better than that in the control group (P < 0.05). Conclusion The clinical effect of Sacubitril Valsartan Sodium Tablets combined with Nitroglycerin Injection in the treatment of senile chronic heart failure is remarkable. It can effectively improve patients' symptoms, improve cardiac function, inhibit ventricular remodeling, not only improve the quality of life, but also promote the improvement of self-care ability, and which is worthy of clinical application.

R972

河南省醫(yī)學(xué)科技攻關(guān)計劃（聯(lián)合共建）項目（LHGJ20190812）