目的 探討沙庫(kù)巴曲纈沙坦鈉聯(lián)合環(huán)磷腺苷葡胺治療舒張性心力衰竭的臨床療效。方法 選取2017年3月-2019年3年在天津市胸科醫(yī)院治療的舒張性心力衰竭患者136例，隨機(jī)分為對(duì)照組（68例）和治療組（68例）。對(duì)照組患者靜脈滴注環(huán)磷腺苷葡胺注射液，90 mg加入5%葡萄糖500 mL，1次/d；治療組在對(duì)照組基礎(chǔ)上口服沙庫(kù)巴曲纈沙坦鈉片，起始劑量50 mg/次，2次/d，逐步增加每天用藥達(dá)到400 mg，連續(xù)服藥15 d。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者心功能指標(biāo)左心室射血分?jǐn)?shù)（LVEF）、左心室收縮末內(nèi)徑（LVESD）、左心室舒張末期內(nèi)徑（LVEDD）和左心室收縮末期容積（LVESV），6 min步行距離，明尼蘇達(dá)心力衰竭生活質(zhì)量量表（MLHFQ）評(píng)分，及血清腦鈉肽（BNP）、超敏C反應(yīng)蛋白（hs-CRP）、醛固酮（ALD）和白細(xì)胞介素-6（1L-6）水平。結(jié)果 治療后，對(duì)照組和治療組臨床總有效率分別為73.53%、95.59%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組LVEF指標(biāo)顯著升高（P<0.05），LVESD、LVEDD和LVESV指標(biāo)顯著降低（P<0.05），且治療組這些心功能指標(biāo)明顯好于對(duì)照組（P<0.05）。治療后，兩組患者6 min步行距離顯著增加（P<0.05），MLHFQ評(píng)分明顯下降（P<0.05），且治療組患者明顯好于對(duì)照組（P<0.05）。治療后，兩組患者血清BNP、1L-6、hs-CRP和ALD水平明顯降低（P<0.05），且治療組患者明顯低于對(duì)照組（P<0.05）。結(jié)論 環(huán)磷腺苷葡胺聯(lián)合沙庫(kù)巴曲纈沙坦鈉治療舒張性心力衰竭，可改善患者心功能，提高患者運(yùn)動(dòng)耐量，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To explore the clinical efficacy of sacubitril valsartan sodium combined with meglumine adenosine cyclophosphate in treatment of diastolic heart failure. Methods Patients (136 cases) with diastolic heart failure in Tianjin Chest Hospital from March 2017 to March 2019 were randomly divided into control (68 cases) and treatment (68 cases) groups. Patients in the control group were iv administered with Meglumine Adenosine Cyclophosphate Injection, 90 mg added into 5% Glucose Injection 500 mL, once daily. Patients in the treatment group were po administered with Sacubitril Valsartan Sodium Tablets on the basis of the control group, and the initial dosage was 50 mg/time, twice daily, then gradually increase to 400 mg/d. Patients in two groups were treated for 15 d. After treatment, the clinical efficacy was evaluated, and the cardiac function indexes of LVEF, LVESD, LVEDD, and LVESV, 6 min walking distance, MLHFQ score, and the serum levels of BNP, IL-6, hs-CRP and ALD in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 73.53% and 95.59%, respectively, and there were differences between two groups (P<0.05). After treatment, the LVEF in two groups was significantly increased (P<0.05), but the LVESD, LVEDD and LVESV levels in two groups were significantly decreased (P<0.05), and the cardiac function indexes in the treatment group were significantly better than those in the control group (P<0.05). After treatment, 6 min walking distance in two groups was significantly increased (P<0.05), but MLHFQ score in two groups were significantly decreased (P<0.05), and the indexes in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the serum levels of BNP, IL-6, hs-CRP and ALD in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Sacubitril valsartan sodium combined with meglumine adenosine cyclophosphate in treatment of diastolic heart failure can improve the heart function of patients, improve exercise tolerance, which has a certain clinical application value.

R972