沙库巴曲缬沙坦钠联合达格列净对冠心病合并慢性心力衰竭患者心功能的影响

doi:10.3969/j.issn.1671-7171.2026.02.024

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摘要 【目的】 探讨沙库巴曲缬沙坦钠联合达格列净对冠心病合并慢性心力衰竭患者心功能的影响。【方法】 选择2021年1月至2024年12月本院收治的118例冠心病合并慢性心力衰竭患者,采用随机数字表法分为对照组(对照组在常规治疗的基础上口服沙库巴曲缬沙坦钠)和观察组(在对照组的基础上口服达格列净),每组59例。比较两组治疗前后的血脂[高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)]水平、心功能[左心室舒张末内径(LVEDD)、左心室收缩末内径(LVESD)、左室射血分数(LVEF)]、心肌损伤标志物[肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白T(cTnT)、B型利钠肽(BNP)]、血管内皮功能[血管舒张功能(FMD)、内皮素(ET)、一氧化氮(NO)]、斑块指标[颈动脉内中膜厚度(IMT)、斑块厚度、斑块面积],并记录患者不良反应发生情况。【结果】 治疗后,两组血清TC、TG、LDL-C水平均低于治疗前,HDL-C水平高于治疗前,且观察组血清TC、TG、LDL-C水平低于对照组,HDL-C水平高于对照组,差异有统计学意义(P<0.05);两组LVEDD 、LVESD 低于治疗前,LVEF高于治疗前,且观察组LVEDD 、LVESD 低于对照组,LVEF高于对照组,差异有统计学意义(P<0.05);两组患者血清cTnT、BNP、CK-MB水平低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组FMD、NO高于治疗前,ET低于治疗前,且观察组FMD、NO高于对照组,ET低于对照组,差异均有统计学意义(P<0.05);两组IMT、斑块厚度、斑块面积低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。【结论】 沙库巴曲缬沙坦钠联合达格列净可改善冠心病合并慢性心力衰竭患者的血管内皮功能、心功能、血脂水平,减轻心肌损伤,且安全性较好。

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	王秀梅
	庄玉

关键词 ：冠心病, 心力衰竭, 慢性病, 缬沙坦, 药物疗法,联合

Abstract：【Objective】 To explore the effect of sacubitril/valsartan sodium combined with dapagliflozin on cardiac function in patients with coronary heart disease (CHD) complicated with chronic heart failure (CHF). 【Methods】 A total of 118 patients with CHD complicated with CHF admitted to our hospital from January 2021 to December 2024 were selected and divided into the control group and the observation group by random number table method, with 59 cases in each group. The control group took sacubitril/valsartan sodium orally on the basis of routine treatment, while the observation group took dapagliflozin orally on the basis of the control group. The blood lipid levels [high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG)], cardiac function [left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF)], myocardial injury markers [creatine kinase isoenzyme (CK-MB), cardiac troponin T (cTnT), B-type natriuretic peptide (BNP)], vascular endothelial function [flow-mediated dilation (FMD), endothelin (ET), nitric oxide (NO)], and plaque indicators [carotid intima-media thickness (IMT), plaque thickness, plaque area] were compared between the two groups before and after treatment, and the occurrence of adverse reactions in patients was recorded.【Results】 After treatment, the serum levels of TC, TG and LDL-C in both groups were lower than those before treatment, and the HDL-C level was higher than that before treatment; moreover, the serum levels of TC, TG and LDL-C in the observation group were lower than those in the control group, and the HDL-C level was higher than that in the control group, with statistically significant differences (P<0.05). The LVEDD and LVESD in both groups were lower than those before treatment, and the LVEF was higher than that before treatment; moreover, the LVEDD and LVESD in the observation group were lower than those in the control group, and the LVEF was higher than that in the control group, with statistically significant differences (P<0.05). The serum levels of cTnT, BNP and CK-MB in both groups were lower than those before treatment, and the observation group was lower than the control group, with statistically significant differences (P<0.05). The FMD and NO in both groups were higher than those before treatment, and ET was lower than that before treatment; moreover, the FMD and NO in the observation group were higher than those in the control group, and ET was lower than that in the control group, with statistically significant differences (P<0.05). The IMT, plaque thickness and plaque area in both groups were lower than those before treatment, and the observation group was lower than the control group, with statistically significant differences (P<0.05). The total incidence of adverse reactions in the observation group was lower than that in the control group, with a statistically significant difference (P<0.05). 【Conclusion】 Sacubitril/valsartan sodium combined with dapagliflozin can improve the vascular endothelial function, cardiac function and blood lipid levels of patients with CHD complicated with CHF, reduce myocardial injury, and has good safety.

Key words： Coronary Disease Heart Failure Chronic Disease Valsartan Drug Therapy, Combination

收稿日期: 2025-06-05

中图分类号:

R542.22

引用本文:

王秀梅, 庄玉. 沙库巴曲缬沙坦钠联合达格列净对冠心病合并慢性心力衰竭患者心功能的影响[J]. 医学临床研究, 2026, 43(2): 265-268.
WANG Xiumei, ZHUANG Yu. The Effect of Sacubitril/Valsartan Sodium Combined with Dapagliflozin on Cardiac Function in Patients with Coronary Heart Disease Complicated with Chronic Heart Failure. JOURNAL OF CLINICAL RESEARCH, 2026, 43(2): 265-268.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2026.02.024 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2026/V43/I2/265

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