目的 探討補益強心片聯(lián)合沙庫巴曲纈沙坦治療慢性心力衰竭的臨床效果。方法 選取2020年7月—2021年8月蚌埠醫(yī)學院第二附屬醫(yī)院收治的98例慢性心力衰竭患者，按隨機數(shù)字表法分成對照組和治療組，每組各49例。對照組口服沙庫巴曲纈沙坦鈉片，100 mg/次，2次/d。治療組在對照組基礎上口服補益強心片，4片/次，3次/d。兩組均連續(xù)治療4周。觀察兩組的臨床療效，比較治療前后兩組超聲心動圖指標[左室射血分數(shù)（LVEF）、左心房容積指數(shù)（LAVI）、二尖瓣舒張期血流E峰與A峰比值（E/A）]，運動耐力[6 min步行距離（6MWD）]和生活質(zhì)量狀況，血液流變學指標[血漿黏度（PV）、紅細胞聚集指數(shù)（EAI）、全血高切黏度（HBV）]，血清N末端B型利鈉肽原（NT-proBNP）、白細胞介素-6（IL-6）、基質(zhì)金屬蛋白酶-9（MMP-9）和內(nèi)皮素-1（ET-1）水平。結(jié)果 治療后，治療組患者總有效率是95.9%，較對照組83.7%顯著提高（P＜0.05）。治療后，兩組LVEF、E/A比治療前均顯著升高，LAVI則均顯著降低（P＜0.05）；且均以治療組改善更顯著（P＜0.05）。治療后，兩組6MWD均較治療前顯著延長，明尼蘇達心功能不全生命質(zhì)量量表（MLHFQ）評分則均較治療前顯著減少（P＜0.05）；但均以治療組改善更顯著（P＜0.05）。治療后兩組PV、EAI、HBV均顯著低于治療前（P＜0.05）；但均以治療組降低更顯著（P＜0.05）。治療后，兩組血清NT-proBNP、IL-6、MMP-9和ET-1水平均顯著低于治療前（P＜0.05）；且均以治療組下降更顯著（P＜0.05）。結(jié)論 補益強心片聯(lián)合沙庫巴曲纈沙坦治療慢性心力衰竭具有較好的臨床療效，可顯著改善患者心功能，并能提高運動耐力和生活質(zhì)量，糾正機體血液流變學異常，減輕心肌損傷和心室重構(gòu)，延緩病情進展，且具有較好的安全性，值得臨床推廣應用。

Objective To investigate the clinical effect of Buyiqiangxin Tablets combined with sacubitril valsartan sodium in treatment of chronic heart failure.Methods A total of 98 patients with chronic heart failure admitted to The Second Affiliated Hospital of Bengbu Medical College from July 2020 to August 2021 were selected and divided into control and treatment groups with 49 cases in each group according to the random number table method.Patients in the control group were po administered with Sacubitril Valsartan Sodium Tablets,100 mg/time,twice daily.Patients in the treatment group were po administered with Buyiqiangxin Tablets on the basis of the control group,4 tablets/time,three times daily.Both groups were treated for 4 weeks.The clinical efficacy of the two groups was observed.The echocardiographic indicators[left ventricular ejection fraction (LVEF),left atrial volume index (LAVI),mitral diastolic blood flow E-peak to A-peak ratio (E/A)]before and after treatment were compared between the two groups,and 6-minute walk Distance (6MWD),Minnesota Heart Failure Quality of Life Scale (MLHFQ) score,hemorheological indices[plasma viscosity (PV),erythrocyte aggregation index (EAI),whole blood high shear viscosity (HBV)],serum N-terminal Pro-B-type natriuretic peptide (NT-proBNP),interleukin-6(IL-6),matrix metalloproteinase-9(MMP-9) and endothelin-1(ET-1) levels was compared.Results After treatment,the total effective rate of the treatment group was 95.9%,which was significantly higher than that of the control group (83.7%)(P<0.05).After treatment,LVEF and E/A in the two groups were significantly increased compared with those before treatment,while LAVI was significantly decreased (P<0.05).The improvement was more significant in the treatment group (P<0.05).After treatment,the 6MWD of the two groups was significantly longer than that before treatment,and the Minnesota Heart Failure Quality of Life Scale (MLHFQ) score was significantly lower than that before treatment (P<0.05).However,the improvement was more significant in the treatment group (P<0.05).After treatment,PV,EAI and HBV in the two groups were significantly lower than those before treatment (P<0.05).However,the reduction was more significant in the treatment group (P<0.05).After treatment,the serum levels of NT-probNP,IL-6,MMP-9 and ET-1 in the two groups were significantly lower than those before treatment (P<0.05).The decrease was more significant in the treatment group (P<0.05).Conclusion Buyiqiangxin Tablets combined with sacubitril valsartan sodium has a good clinical effect in treatment of chronic heart failure,and can significantly improve the cardiac function of patients,improve exercise endurance and life quality,correct the abnormal hemorheology of the body,reduce myocardial injury and ventricular remodeling,delay the progression of the disease,and has good safety,which is worthy of clinical application.

R972

安徽省高校自然科學項目(KJ2018A0242)