目的 探讨单硝酸异山梨酯片联合沙库巴曲缬沙坦钠治疗慢性心力衰竭的临床疗效。方法 选取2020年7月—2022年11月首都医科大学附属潞河医院收治的慢性心力衰竭患者106例。依据用药情况分为对照组和治疗组，每组各53例。对照组口服沙库巴曲缬沙坦钠片，100 mg/次，2次/d。在对照组基础上，治疗组口服单硝酸异山梨酯片，20 mg/次，2次/d。两组治疗7 d。观察两组患者临床疗效，比较治疗前后两组患者症状改善时间，6 min步行距离试验量表（6MWT）和日常生活活动能力量表（ADL）评分，及血清白细胞介素-1β（IL-1β）、N-端脑肽前体（NT-proBNP）、可溶性生长刺激表达基因2蛋白（sST2）和多配体蛋白聚糖1（SDC1）水平。结果 治疗后，治疗组总有效率为94.33%，明显高于对照组（81.13%，P＜0.05）。治疗后，治疗组呼吸困难、疲倦、乏力、心慌改善时间均明显早于对照组（P＜0.05）。治疗后，两组患者6MWT试验、ADL评分均比治疗前明显升高（P＜0.05），且治疗组明显高于对照组（P＜0.05）。治疗后，两组患者血清IL-1β、NT-proBNP、sST2、SDC1水平比治疗前明显降低（P＜0.05），且治疗组明显低于对照组（P＜0.05）。结论 单硝酸异山梨酯与沙库巴曲缬沙坦钠协同治疗，可有效改善心衰症状，明显提升患者心功能及日常生活质量，减弱机体炎性反应，且安全有效，值得借鉴应用。

Objective To explore the clinical effect of Isosorbide Mononitrate Tablets combined with sacubitril valsartan sodium in treatment of chronic heart failure. Methods Patients (106 cases) with chronic heart failure in Beijing Luhe Hospital, Capital Medical University from July 2020 to November 2022 were divided into control and treatment group according to different treatment, and each group had 53 cases. Patients in the control group were po administered with Sacubitril Valsartan Sodium Tablets, 100 mg/time, twice daily. Patients in the treatment group were po administered with Isosorbide Mononitrate Tablets on the basis of the control group, 20 mg/time, twice daily. Patients in two groups were treated for 7 d. After treatment, the clinical evaluations were evaluated, the symptom relief time, 6MWT trials and ADL scores, and the levels of serum IL-1β, NT-proBNP, sST2 and SDC1 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 94.33%, which was significantly higher than that of the control group (81.13%, P < 0.05). After treatment, the improvement time of dyspnea, fatigue, fatigue and palpitation in the treatment group was significantly earlier than that in the control group (P < 0.05). After treatment, the scores of 6MWT test and ADL in two groups were significantly higher than those before treatment (P < 0.05), and which in the treatment group were significantly higher than those in the control group (P < 0.05). After treatment, the levels of serum IL-1β, NT-proBNP, sST2 and SDC1 in two groups were significantly lower than those before treatment (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion The synergistic treatment of isosorbide mononitrate and sacubitril valsartan sodium can effectively improve the symptoms of heart failure, significantly improve the cardiac function and quality of daily life of patients, and weaken the inflammatory response, which is safe and effective, which is worth using for reference.

R972

北京市通州区支持科技创新专项项目（KJ2018CX009-40）