沙库巴曲缬沙坦联合卡维地洛治疗不同病因老年人慢性心力衰竭的有效性和安全性分析

The efficacy and safety of sacubitril and valsartan combined with carvedilol in the treatment of elderly patients with chronic heart failure of different etiologies

摘要:

目的 探讨沙库巴曲缬沙坦联合卡维地洛治疗不同病因老年人慢性心力衰竭的疗效。方法 选取2019年3月—2021年2月常州市第四人民医院收治的89例慢性心力衰竭患者，依据病因将其分为冠状动脉粥样硬化性心脏病（以下简称冠心病）组（45例）、高血压心脏病组（16例）和扩张型心肌病组（28例）。所有患者采用沙库巴曲缬沙坦联合卡维地洛连续治疗3个月。对比3组患者心功能指标、临床疗效、血清学指标及治疗期间不良反应。结果 治疗前，3组患者左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）、左心室射血分数（LVEF）及心脏指数比较，差异无统计学意义（P >0.05）；治疗后3组患者LVEDD、LVESD均低于治疗前（P <0.05），LVEF及心脏指数则均高于治疗前（P <0.05）；治疗后3组患者LVEDD、LVESD、LVEF及心脏指数比较，差异无统计学意义（P >0.05）。3组患者临床疗效、总有效率比较，差异无统计学意义（P >0.05）。3组患者不良反应发生率比较，差异无统计学意义（P >0.05）。结论 沙库巴曲缬沙坦联合卡维地洛可用于治疗老年人慢性心力衰竭，且不同病因慢性心力衰竭老年患者的临床疗效及不良反应相近。

Abstract:

Objective To investigate the therapeutic effect of sacubitril and valsartan combined with carvedilol in elderly patients with chronic heart failure arising from different etiologies.Methods A total of 89 patients with chronic heart failure admitted to Changzhou Fourth People's Hospital from March 2019 to February 2021 were selected and divided into coronary heart disease group (45 cases), hypertensive heart disease group (16 cases) and dilated cardiomyopathy group (28 cases) according to the etiologies. All patients were treated with sacubitril and valsartan combined with carvedilol for 3 months. The cardiac function parameters, clinical efficacy, serological indicators and adverse reactions during the treatment were compared among the three groups of patients.Results There was no difference in left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), left ventricular ejection fraction (LVEF) and cardiac index among the three groups before the treatment (P > 0.05). The LVEDD and LVESD of the three groups were all lower after the treatment than those before the treatment (P < 0.05), while the LVEF and cardiac index were higher after the treatment than those before the treatment (P < 0.05). After the treatment, LVEDD, LVESD, LVEF and cardiac index were not different among the three groups (P > 0.05). There was also no difference in the clinical efficacy, the overall effective rate, or the incidence of adverse reactions among the three groups of patients (P > 0.05).Conclusions The sacubitril and valsartan combined with carvedilol can be applied in the treatment of elderly patients with chronic heart failure, with parallel clinical efficacy and adverse reactions among the patients with chronic heart failure due to different etiologies.