目的 探討單硝酸異山梨酯片聯(lián)合沙庫巴曲纈沙坦鈉治療慢性心力衰竭的臨床療效。方法 選取2020年7月—2022年11月首都醫(yī)科大學(xué)附屬潞河醫(yī)院收治的慢性心力衰竭患者106例。依據(jù)用藥情況分為對照組和治療組，每組各53例。對照組口服沙庫巴曲纈沙坦鈉片，100 mg/次，2次/d。在對照組基礎(chǔ)上，治療組口服單硝酸異山梨酯片，20 mg/次，2次/d。兩組治療7 d。觀察兩組患者臨床療效，比較治療前后兩組患者癥狀改善時間，6 min步行距離試驗(yàn)量表（6MWT）和日常生活活動能力量表（ADL）評分，及血清白細(xì)胞介素-1β（IL-1β）、N-端腦肽前體（NT-proBNP）、可溶性生長刺激表達(dá)基因2蛋白（sST2）和多配體蛋白聚糖1（SDC1）水平。結(jié)果 治療后，治療組總有效率為94.33%，明顯高于對照組（81.13%，P＜0.05）。治療后，治療組呼吸困難、疲倦、乏力、心慌改善時間均明顯早于對照組（P＜0.05）。治療后，兩組患者6MWT試驗(yàn)、ADL評分均比治療前明顯升高（P＜0.05），且治療組明顯高于對照組（P＜0.05）。治療后，兩組患者血清IL-1β、NT-proBNP、sST2、SDC1水平比治療前明顯降低（P＜0.05），且治療組明顯低于對照組（P＜0.05）。結(jié)論 單硝酸異山梨酯與沙庫巴曲纈沙坦鈉協(xié)同治療，可有效改善心衰癥狀，明顯提升患者心功能及日常生活質(zhì)量，減弱機(jī)體炎性反應(yīng)，且安全有效，值得借鑒應(yīng)用。

Objective To explore the clinical effect of Isosorbide Mononitrate Tablets combined with sacubitril valsartan sodium in treatment of chronic heart failure. Methods Patients (106 cases) with chronic heart failure in Beijing Luhe Hospital, Capital Medical University from July 2020 to November 2022 were divided into control and treatment group according to different treatment, and each group had 53 cases. 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 Isosorbide Mononitrate Tablets on the basis of the control group, 20 mg/time, twice daily. Patients in two groups were treated for 7 d. After treatment, the clinical evaluations were evaluated, the symptom relief time, 6MWT trials and ADL scores, and the levels of serum IL-1β, NT-proBNP, sST2 and SDC1 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 94.33%, which was significantly higher than that of the control group (81.13%, P < 0.05). After treatment, the improvement time of dyspnea, fatigue, fatigue and palpitation in the treatment group was significantly earlier than that in the control group (P < 0.05). After treatment, the scores of 6MWT test and ADL in two groups were significantly higher than those before treatment (P < 0.05), and which in the treatment group were significantly higher than those in the control group (P < 0.05). After treatment, the levels of serum IL-1β, NT-proBNP, sST2 and SDC1 in two groups were significantly lower than those before treatment (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion The synergistic treatment of isosorbide mononitrate and sacubitril valsartan sodium can effectively improve the symptoms of heart failure, significantly improve the cardiac function and quality of daily life of patients, and weaken the inflammatory response, which is safe and effective, which is worth using for reference.

R972

北京市通州區(qū)支持科技創(chuàng)新專項(xiàng)項(xiàng)目（KJ2018CX009-40）