摘要
Abstract
Objective:To observe the efficacy of Metoprolol combined with Sacubitril Valsartan in the treatment of coronary heart disease with chronic heart failure,and to explore the effects on vascular inflammatory response,myocardial remodeling and vascular endothelial function of patients.Method:A total of 80 patients with coronary heart disease complicated with chronic heart failure admitted to Shangrao People's Hospital from January 2018 to December 2022 were selected,and divided into a conventional group and a combined group by random number table method,with 40 cases in each group.The conventional group was treated with Metoprolol,and the combined group was additionally given Sacubitril Valsartan on the basis of the conventional group.The clinical therapeutic effect,serum detection indicators[serum soluble CD40 ligand(sCD40L),plasma adipokine chemokine(Chemerin),serum hypersensitive C reactive protein(hs-CRP)],myocardial remodeling indicators[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)]and vascular endothelial function indicators[plasma endothelin(ET),calcitonin gene-related peptide(CGRP),plasma nitric oxide(NO)]and occurrence of adverse reactions were compared between the two groups.Result:After treatment,the total effective rate in combined group was significantly higher than that in conventional group(P＜0.05).Before treatment,there were no statistical differences in the levels of sCD40L,Chemerin and hs-CRP between the two groups(P＞0.05);after treatment,the sCD40L,Chemerin and hs-CRP levels in two groups were decreased compared with those before treatment,and those in combined group were significantly lower than those in conventional group,the differences were statistically significant(P＜0.05).Before treatment,the LVEF,LVEDD and LVESD showed no statistical differences between the two groups(P＞0.05);after treatment,the LVEF in combined group was significantly higher than that in conventional group while the LVEDD and LVESD were significantly lower than those in conventional group,the differences were statistically significant(P＜0.05).Before treatment,there were no significant differences in the levels of ET,CGRP and NO between the two groups(P＞0.05);after treatment,the ET level in combined group was significantly lower than that of conventional group,while the CGRP and NO levels were significantly higher than those of conventional group(P＜0.05).There was no statistical difference in the incidence rate of adverse reactions between the two groups(P＞0.05).Conclusion:The combined application of Sacubitril Valsartan and Metoprolol has an obvious efficacy in treating coronary heart disease with chronic heart failure,and it can improve the cardiac function,relieve the vascular inflammatory response,reverse the myocardial remodeling,and correct the vascular endothelial function of patients,and it has high safety.关键词
美托洛尔/沙库巴曲缬沙坦钠/冠心病/慢性心力衰竭/可溶性CD40配体/血浆脂肪因子趋化素Key words
Metoprolol/Sacubitril Valsartan/Coronary heart disease/Chronic heart failure/Soluble CD40 ligand/Plasma adipokine chemokine
