【摘要】 目的 探讨沙库巴曲缬沙坦联合生脉注射液治疗慢性心力衰竭的效果。方法 选取2022年6月至2024年4月大连理工大学附属中心医院收治的100例慢性心力衰竭患者，用抽签法随机分为观察组与对照组，各50例。对照组服用沙库巴曲缬沙坦，观察组在对照组基础上联用生脉注射液治疗。比较两组患者治疗有效率、心功能[左室收缩末期内径（LVESD）、6min步行试验（6MWT）、左室短轴缩短率（LVFS）、左室舒张末期内径（LVEDD）、静脉血液流速比（E/A）、左室射血分数（LVEF）]、心肌损伤标志物[肌钙蛋白T（cTnT）、N末端脑钠肽前体（NT-proBNP）及血管紧张素Ⅱ（AngⅡ）]、炎症因子[基质金属蛋白酶组织抑制剂1（TIMP-1）、白细胞介素-6（IL-6）、转化生长因子-β₁（TGF-β₁）和白细胞介素-18（IL-18）]水平。结果 观察组治疗有效率高于对照组（P<0.05）；治疗后，两组LVESD、6MWT、LVFS、LVEDD、E/A和LVEF升高（P<0.05），且观察组LVESD、6MWT、LVFS、LVEDD、E/A和LVEF高于对照组（P<0.05）；治疗后，两组cTnT、NT-proBNP和AngⅡ水平降低（P<0.05），且观察组低于对照组（P<0.05）；治疗后两组血清TIMP-1、TGF-β₁水平升高，IL-6、IL-18水平降低，且观察组血清TIMP-1、TGF-β₁水平高于对照组，IL-6、IL-18水平低于对照组，差异有统计学意义（P<0.05）；两组头晕头痛、心悸乏力、胃肠道反应和皮疹发生率无明显差异（P>0.05）。结论 沙库巴曲缬沙坦联合生脉注射液能明显改善慢性心力衰竭患者的心功能，减轻心肌损伤程度和炎症反应，疗效显著，且安全性较高。更多还原

【Abstract】 Objective To explore the effect of sacubitril/valsartan combined with Shengmai Injection in the treatment of chronic heart failure. Methods One hundred patients with chronic heart failure admitted to the Affiliated Central Hospital of Dalian University of Technology from June 2022 to April 2024 were selected and randomly divided into the observation group and the control group by lottery, with 50 cases in each group. The control group was treated with sacubitril/valsartan, while the observation group was treated with Shengmai Injection in combination on the basis of the control group. The effective rate of treatment, cardiac functions [left ventricular end-systolic diameter（LVESD）, 6-minute walk test（6MWT）, left ventricular shortening rate（LVFS）, left ventricular end-diastolic diameter（LVEDD）, venous blood flow velocity ratio（E/A）, left ventricular ejection fraction（LVEF）], and myocardial injury markers [troponin T（cTnT）, N-terminal pro-brain natriuretic peptide（NT-proBNP）, angiotensin Ⅱ（Ang Ⅱ）,and inflammatory factors [tissue inhibitor of matrix metalloproteinase 1（TIMP-1）, interleukin-6（IL-6）, transforming growth factor-β₁（TGF-β₁）, and interleukin-18（IL-18）] were compared between the two groups of patients. Results The effective rate of treatment in the observation group was higher than that in the control group（P<0.05）. After treatment, LVESD, 6MWT, LVFS,LVEDD, E/A and LVEF in both groups increased（P<0.05）, and LVESD, 6MWT, LVFS, LVEDD, E/A and LVEF in the observation group were higher than those in the control group（P<0.05）. After treatment, the levels of cTnT, NT-proBNP and AngⅡin both groups decreased（P<0.05）, and those in the observation group were lower than those in the control group（P<0.05）. After treatment, the levels of serum TIMP-1 and TGF-β₁ in both groups increased, while the levels of IL-6 and IL-18 decreased. Moreover, the levels of serum TIMP-1 and TGF-β₁ in the observation group were higher than those in the control group, and the levels of IL-6 and IL-18were lower than those in the control group. The differences were statistically significant（P<0.05）. There was no significant difference in the incidence of dizziness, headache, palpitations, fatigue, gastrointestinal reactions and rash between the two groups（P>0.05）. Conclusion Sacubitril/valsartan combined with Shengmai Injection can significantly improve the cardiac function of patients with chronic heart failure, reduce the degree of myocardial injury and inflammatory response, with remarkable therapeutic effect and high safety.更多还原