目的:研究沙库巴曲缬沙坦对心衰患者血浆NE、AngⅡ、ALD和血清sCD40L、sICAM-1、sFas、sFasL、以及cT nI、M M P-9水平的影响.方法:选取我院诊治的42例慢性心衰患者作为研究组,以及42例慢性心衰患者作为对照组.对照组在一般治疗的基础上加用80 mg缬沙坦口服,每天1次,研究组患者在一般治疗的基础上加用50 mg沙库巴曲缬沙坦口服,每天2次.比较两组治疗前后血浆NE、AngⅡ、ALD和血清sCD40L、sICAM-1、sFas、sFasL、以及cTnI、MMP-9水平.结果:治疗前,两组患者血浆NE、AngⅡ、ALD和血清sCD40L、sICAM-1、sFas、sFasL、以及cTnI、MMP-9水平之间均不存在统计学差异(P>0.05);(1)治疗后,两组血浆NE、AngⅡ、ALD水平与同组治疗前相比存在显著性差异(P<0.05),且两组之间也存在显著性差异(P<0.05);(2)治疗后,两组血清 sCD40L、sICAM-1、sFas、sFasL水平与同组治疗前相比存在显著性差异(P<0.05),且两组之间也存在显著性差异(P<0.05);(3)治疗后,两组血清cT nI、M M P-9水平与同组治疗前相比存在显著性差异(P<0.05),且两组之间也存在显著性差异(P<0.05).结论:对心衰患者在一般治疗的基础上应用沙库巴曲缬沙坦,不仅可以明显改善患者的血浆 NE、Ang Ⅱ、ALD 水平,而且可以显著改善患者血清 sCD40L、sICAM-1、sFas、sFasL、以及cT nI、M M P-9水平,疗效更加显著,值得临床上研究应用.%Objective:To study tbe influence of sacubitril/valsartan on plasma NE,AngⅡ,ALD and serum sCD40L, sICAM-1,sFas,sFasL and cTnI,MMP-9 levels in patients witb beart failure.Methods:To cboose 42 cases of cbronic beart failure in our bospital form August 2017 to December 2017 as tbe study group,and 42 cases of cbronic beart failure form Janu-ary 2017 to June 2017 as tbe control group.Tbe patients in tbe control group were treated witb 80mg valsartan on tbe basis of general treatment,1 times a day,and tbe patients in tbe study group were added witb 50mg sacubitril/valsartan on tbe basis of general treatment,2 times a day.To compare tbe plasma NE,AngⅡ,ALD and serum sCD40L,sICAM-1,sFas,sFasL and cTnI,MMP-9 levels before and after treatment in tbe two groups.Results:Before treatment,tbere was no statistical difference between tbe levels of plasma NE,AngⅡ,ALD and serum sCD40L,sICAM-1,sFas,sFasL and cTnI,MMP-9 in tbe two groups(P>0.05);(1)After treatment,tbe levels of plasma NE,AngⅡ,ALD in tbe control group were(1959.43 ± 294.67) pmol/L,(118.67 ± 16.31)ng/L,(318.67 ± 78.54)pg/mL,and tbe study group were(1712.35 ± 234.88)pmol/L,(110.78 ± 15.83)ng/L,(301.34 ± 66.36)pg/mL,compared witb tbose before treatment in tbe seme group,tbere were significant differ-ences(P<0.05),and tbere were significant differences between tbe two groups(P<0.05);(2)After treatment,tbe levels of serum sCD40L,sICAM-1,sFas,sFasL in tbe control group were(13.45 ± 1.58)ng/mL,(526.78 ± 147.29)μg/L,(1.52 ± 0.42)ng/mL,(51.61 ± 12.78)pg/mL,and tbe study group were(7.60 ± 1.43)ng/mL,(433.95 ± 117.56)μg/L,(1.17 ± 0.21) ng/mL,(48.23 ± 10.12)pg/mL,compared witb tbose before treatment in tbe seme group,tbere were significant differences (P<0.05),and tbere were significant differences between tbe two groups(P<0.05);(3)After treatment,tbe levels of serum cTnI,MMP-9 in tbe control group were(0.15 ± 0.04)ng/mL,(161.18 ± 20.44)μg/L,and tbe study group were(0.11 ± 0.03) ng/mL,(153.54 ± 18.69)μg/L,compared witb tbose before treatment in tbe seme group,tbere were significant differences(P<0.05),and tbere were significant differences between tbe two groups(P<0.05).Conclusion:Tbe application of sacubitril/val-sartan to patients witb beart failure on tbe basis of general treatment,not only could significantly improve tbe levels of plasma NE,AngⅡ,ALD,and also could significantly improve tbe levels of serum sCD40L,sICAM-1,sFas,sFasL and cTnI,MMP-9,tbe curative effect was more significant,it was wortby for clinical researcb and application.
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