维立西呱联合沙库巴曲缬沙坦治疗慢性心力衰竭患者的临床研究OA

Objective To explore the clinical efficacy and safety of vericiguat tablets(VER)combined with sacubitril valsartan sodium tablets on chronic heart failure(CHF).Methods CHF patients were divided into the control group and the treatment group based on different treatment regimens.The control group was administered sacubitril valsartan sodium tablets orally,100 mg each time,twice a day,for 3 months.The treatment group received additional vericiguat tablets treatment on basis of control group.The initial dose was 2.5 mg each time,once a day.After two weeks,the dose was gradually increased up to a maximum of 10 mg per day,for a total of 3 months of treatment.The cardiac function,myocardial energy metabolism,hemodynamics,serological indicators,total effective rate and safety were compared.Results A total of 104 cases were selected.There were 52 cases in the treatment group and 52 cases in the control group.There were no dropout cases in the treatment group.In the control group,2 cases dropped out due to poor compliance.In the end,52 cases were included in the treatment group and 50 cases in the control group.The total effective rates of the treatment group and the control group were 94.23％(49 cases/52 cases)and 80.00％(40 cases/50 cases)respectively;the difference was statistically significant(P＜0.05).After treatment,the left ventricular end-diastolic diameter(LVEDD)in the treatment group and the control group were(47.42±4.98)and(51.25±5.86)mm,respectively;the stroke volume(SV)was(68.82±7.37)and(63.97±6.74)mL,respectively;the left ventricular ejection fraction(LVEF)were(56.88±5.96)％and(53.35±5.53)％,respectively;myocardial energy expenditure(MEE)were(101.68±11.72)and(108.69±12.95)cal·min-1,respectively;free fatty acids(FFA)were(652.11±67.64)and(692.03±70.85)μmol·L-1,respectively;the cardiac output(CO)were(5.16±0.75)and(4.69±0.63)L·min-1,respectively;the cardiac output index(CI)was(2.82±0.45)and(2.53±0.38)L·min-1·m-2,respectively;fibroblast growth factor 23(FGF23)were(29.38±3.43)and(32.04±4.67)ng·mL-1,respectively;N-terminal pro-brain natriuretic peptide(NT-proBNP)were(363.24±39.86)and(390.06±43.31)pg·mL-1,respectively;transcription factor fork box protein O1(FOXO1)were(2.43±0.37)and(2.72±0.45)ng·mL-1,respectively;Compared between the treatment group and the control group,the differences of above indicators were all astatistically significant difference(all P＜0.05).The total incidence of adverse drug reactions in the treatment group and the control group was 13.46％(7 cases/52 cases)and 8.00％(4 cases/50 cases),with no statistically significant difference(P＞0.05).Conclusion The combination of vericiguat tablets and sacubitril valsartan sodium tablets for CHF patients can effectively reduce myocardial tissue damage,regulate hemodynamic levels,promote the recovery of myocardial energy metabolism,prevent ventricular remodeling,and with relatively ideal overall protective effect on cardiac function.