目的 探究桂哌齐特联合沙库巴曲缬沙坦治疗射血分数降低心力衰竭（HFrEF）的临床效果。方法 回顾性选取 2019年6月—2020年9月解放军第九六〇医院收治的80例HFrEF患者作为研究对象，根据治疗方法分为试验组、对照组，各40例。对照组患者采用沙库巴曲缬沙坦片治疗，初始剂量为50 mg/次，口服，2次/d，之后根据患者情况每2～4周剂量倍增1次，最大剂量不超过200 mg/次。试验组患者在对照组基础上加用马来酸桂哌齐特注射液240 mg，马来酸桂哌齐特注射液与250 mL0.9%氯化钠注射液混合，静脉滴注，1次/d。两组均治疗4周。比较两组疗效及两组患者治疗前后心功能、6 min步行试验距离（6MWT）、心衰标志物、左室重构情况，比较治疗后两组不良心血管事件（MACE）发生率及治疗期间不良反应发生率。结果 试验组总有效率为92.50%显著高于对照组的75.00%（P<0.05）；治疗后两组心排血量（CO）、左室射血分数（LVEF）均显著增加（P<0.05），左心室舒张末期内径（LVEDD）水平均显著降低（P<0.05），血清可溶性生长刺激表达基因2蛋白（sST2）、N末端脑钠肽原（NT-proBNP）、胱抑素C （Cys C）、金属蛋白酶抑制剂-1 （TIMP-1）、基质金属蛋白酶-9（MMP-9）水平均显著降低（P<0.05），6MWT显著延长（P<0.05）。治疗后试验组CO、LVEF高于对照组（P<0.05），LVEDD低于对照组（P<0.05），6MWT长于对照组（P<0.05）；治疗后试验组血清sST2、NT-proBNP、CysC、TIMP-1、MMP-9水平低于对照组（P<0.05）。两组MACE发生率、不良反应发生率比较，差异无统计学意义（P>0.05）。结论 马来酸桂哌齐特注射液联合沙库巴曲缬沙坦治疗HFrEF患者效果显著，可有效提高患者运动耐力及心功能，降低心衰标志物水平，逆转心室重构，且安全性较高。

Objective To investigate the clinical effect of cinepazide combined with sacubatrovalsartan in the treatment of ejection fraction reduced heart failure (HFrEF). Methods Total 80 patients with HFrEF treated in the 960 Hospital of the PLA from June 2019 to September 2020 were retrospectively selected as the research objects. According to the treatment methods, they were divided into experimental group and control group, with 40 cases in each group. Patients in the control group were treated with Sacubatrovalsartan Tablets. The initial dose was 50 mg/time, orally, twice a day. Then, according to the patient's situation, the dose doubled once every 2—4 weeks, and the maximum dose did not exceed 200 mg/time. On the basis of the control group, the patients in the experimental group were added with Cinepazide Maleate Injection, 240 mg Cinepazide Maleate Injection and 250 mL 0.9% sodium chloride injection, intravenous drip, once a day. Both groups were treated for 4 weeks. The curative effects of the two groups were compared. The cardiac function, 6-min walking test distance (6MWT), markers of heart failure and left ventricular remodeling of the two groups were compared before and after treatment. The incidence of adverse cardiovascular events (MACE) and adverse reactions during treatment were compared between the two groups. Results The total effective rate in the experimental group was 92.50%, which was significantly higher than 75.00% in the control group (P<0.05). After treatment, cardiac output (CO), left ventricular ejection fraction (LVEF) increased significantly (P<0.05), left ventricular end diastolic diameter (LVEDD) decreased significantly (P<0.05) in two groups. After treatment, the levels of serum soluble growth stimulating gene 2 protein (sST2), Nterminal pro brain natriuretic peptide (NT proBNP), Cystatin C (Cys C), metalloproteinase inhibitor-1 (TIMP-1) and matrix metalloproteinase-9 (MMP-9) decreased significantly (P<0.05) in two groups, and 6MWT prolonged significantly (P<0.05). After treatment, CO and LVEF in the experimental group were higher than those in the control group (P<0.05), LVEDD was lower than that in the control group (P<0.05), and 6MWT was longer than that in the control group (P<0.05). After treatment, the levels of serum sST2, NT proBNP, Cys C, TIMP-1 and MMP-9 in the experimental group were lower than those in the control group (P<0.05). There was no significant difference in the incidence of mace and adverse reactions between the two groups (P>0.05). Conclusion Cinepazide Maleate Injection combined with sacubatrovalsartan is effective in the treatment of patients with HFrEF. It can effectively improve exercise endurance and cardiac function, reduce the level of markers of heart failure, reverse ventricular remodeling, and has high safety.

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