【摘要】 目的：探讨不同剂量沙库巴曲缬沙坦治疗慢性心力衰竭（CHF）的疗效及对患者血清脂联素（APN）、胱抑素C(CysC)、氨基末端脑钠肽前体（NT-proBNP）的影响。方法：选取2020年3月—2023年12月大同市第五人民医院收治的90例CHF患者，随机分为单药组、低剂量联合组、高剂量联合组，每组30例。单药组采用阿托伐他汀治疗，低剂量联合组采用阿托伐他汀+50 mg沙库巴曲缬沙坦治疗，高剂量联合组采用阿托伐他汀+100 mg沙库巴曲缬沙坦治疗，对比三组治疗效果、心功能指标、APN、CysC、NT-proBNP水平变化，并对比三组不良反应发生情况。结果：治疗后，高剂量联合组和低剂量联合组总有效率高于单药组（P<0.05）；高剂量联合组6分钟步行距离、左室射血分数高于低剂量联合组与单药组（P<0.05）；高剂量联合组APN、CysC、NT-proBNP低于低剂量联合组与单药组（P<0.05）；三组不良反应发生率比较，差异无统计学意义（P>0.05）。结论：针对慢性心力衰竭患者，在常规阿托伐他汀基础上增加沙库巴曲缬沙坦治疗剂量疗效更高，且可改善患者心功能，并降低APN、CysC、NT-proBNP水平，且增加沙库巴曲缬沙坦用药剂量后并不增加患者不良反应情况。更多还原

【Abstract】 Objective: To investigate the efficacy of different doses of sacubitril valsartan in the treatment of chronic heart failure(CHF)and its effects on serum adiponectin(APN), cystatin C(CysC)and N-terminal pro-brain natriuretic peptide(NT-proBNP). Methods: A total of 90 CHF patients admitted to the Fifth People’s Hospital of Datong from March 2020 to December 2023 were randomly divided into single drug group, low-dose combined group and highdose combined group, with 30 patients in each group. The single drug group was treated with atorvastatin, the low-dose combined group was treated with atorvastatin+50 mg sacubitril valsartan, and the high-dose combined group was treated with atorvastatin+100 mg sacubitril valsartan. The therapeutic effect,cardiac function index, APN, CysC and NT-proBNP levels of the three groups were compared, and the adverse reactions of the three groups were compared.Results: After treatment, the total effective rate of the high-dose combined group and the low-dose combined group was higher than that of the single drug group(P<0.05). The 6-minute walking distance and left ventricular ejection fraction in the high-dose combined group were higher than those in the lowdose combined group and the single drug group(P<0.05). APN, CysC and NT-proBNP in the high-dose combination group were lower than those in the lowdose combination group and the single drug group(P<0.05). There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05). Conclusion: For patients with chronic heart failure, increasing the therapeutic dose of sacubitril valsartan on the basis of conventional atorvastatin is more effective, and can improve the cardiac function of patients, and reduce the levels of APN, CysC and NT-proBNP, and increase the dosage of sacubitril valsartan does not increase the adverse reactions of patients.更多还原