目的 探究沙庫(kù)巴曲纈沙坦治療慢性心功能不全的療效。方法 選取2018年11月—2019年12月河北北方學(xué)院附屬第一醫(yī)院治療的84例慢性心功能不全患者作為研究對(duì)象，根據(jù)治療方法將患者分為對(duì)照組和觀察組，每組各42例。對(duì)照組采用常規(guī)藥物治療。觀察組在對(duì)照組治療基礎(chǔ)上口服沙庫(kù)巴曲纈沙坦鈉片，患者在停止服用ACEI類(lèi)藥物2 d后，口服沙庫(kù)巴曲纈沙坦鈉片，初始劑量為50 mg/次，2次/d，后根據(jù)患者病情變化及藥物耐受情況，逐漸增加劑量至200 mg/次，持續(xù)治療3個(gè)月。觀察兩組的臨床療效，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）、左心室舒張末期內(nèi)徑（LVEDD）、左心室收縮末期內(nèi)徑（LVESD）］和血清學(xué)指標(biāo)［血清N末端B型鈉尿肽前體（NT-proBNP）、基質(zhì)金屬蛋白酶-9（MMP-9）和可溶性生長(zhǎng)刺激表達(dá)基因2蛋白（sST2）］的水平變化，以及堪薩斯城心肌病患者生活質(zhì)量量表（KCCQ）評(píng)分情況。結(jié)果 治療后，觀察組總有效率為88.10%，顯著高于對(duì)照組總有效率的66.67%，兩組間比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者LVEDD、LVESD均比治療前降低，LVEF顯著升高（P<0.05）；且治療后觀察組LVEDD、LVESD均明顯低于對(duì)照組，LVEF明顯高于對(duì)照組（P<0.05）。治療后，兩組患者NT-proBNP、MMP-9和sST2均顯著降低（P<0.05）；且治療后觀察組NT-proBNP、MMP-9和sST2水平明顯低于對(duì)照組（P<0.05）。治療后，兩組患者KCCQ評(píng)分均顯著升高（PP<0.05）；且治療后觀察組KCCQ評(píng)分顯著高于對(duì)照組（P<0.05）。結(jié)論 沙庫(kù)巴曲纈沙坦治療慢性心功能不全療效好，可有效改善患者心功能，提高患者生活質(zhì)量，具有臨床推廣價(jià)值。

Objective To investigate the efficacy of sacubitril valsartan in treatment of chronic cardiac insufficiency. Methods Eighty-four patients with chronic cardiac insufficiency treated in the First Affiliated Hospital of Hebei North University from November 2018 to December 2019 were selected as the research subjects. According to the treatment methods, the patients were randomly divided into control group and observation group, with 42 cases in each group. Patients in the control group was treated with conventional drugs. Patients in the observation group were po administered with Sacubitril Valsartan Sodium Tablets on the basis of control group, and the patients were given Sacubitril Valsartan Sodium Tablets with an initial dose of 50 mg/time, twice daily after stopping ACII drugs 2 days, and then the dose was gradually increased to 200 mg/time according to the changes in patients' condition and drug tolerance for 3 months. The clinical efficacy of two groups was observed. Cardiac function indexes (LVEF, LVEDD, LVESD), serological indexes (NT-proBNP, MMP-9, and sST2), and KCCQ scores were compared between two groups before and after treatment. Results After treatment, the total effective rate of the observation group was 88.10%, which was significantly higher than that of the control group (66.67%), and the difference between the two groups was statistically significant (P < 0.05). After treatment, LVEDD and LVESD in two groups were decreased compared with before treatment, while LVEF was significantly increased (P < 0.05). After treatment, LVEDD and LVESD in the observation group were significantly lower than those in the control group, and LVEF was significantly higher than those in the control group (P < 0.05). After treatment, NT-proBNP, MMP-9 and sST2 in two groups were significantly decreased (P < 0.05). After treatment, the levels of NT-proBNP, MMP-9 and SST2 in observation group were significantly lower than those in control group (P < 0.05). After treatment, KCCQ scores in two groups were significantly increased (P < 0.05). After treatment, the KCCQ score in observation group was significantly higher than that in control group (P < 0.05). Conclusions Sacubitril valsartan has good efficacy in treatment of chronic cardiac insufficiency, which can effectively improve the cardiac function of patients and improve the quality of life of patients, and has clinical promotion value.

R972

2020年度河北省醫(yī)學(xué)科學(xué)研究課題計(jì)劃（20200537）