沙库巴曲缬沙坦治疗心衰合并缺血性脑卒中日常生活能力的疗效观察

Treatment of Heart Failure Combined with Ischemic Stroke with Sacubitril Valsartan and Observation on the Efficacy of ADL

摘要: 目的：分析沙库巴曲缬沙坦(ARNI)治疗射血分数减低心衰合并缺血性脑卒中的日常生活能力(ADL)疗效。方法：观察性分析自2020年10月~2021年10月青岛大学附属威海市立二院收治的射血分数减低心功能不全合并缺血性脑卒中日常生活能力轻中度依赖的120例患者的临床资料相关数据，按照治疗差异(是否服用ARNI)将120例患者分为对照组与观察组，每组各60例，收集两组患者6个月门诊随访结果，记录每回复诊的临床数据。对照组收取常规的简单的治疗方式治疗的患者的相关指标结果，观察组收取选用常规的药物治疗方式加用沙库巴曲缬沙坦治疗的相关指标结果，分析两组患者卒中再入院率及ADL复原情况(Barthel指数)、治疗的总有效率、治疗前后心功能相关具体指标、治疗前后实验室指标、治疗后的不良反应发生率等。结果：分析收取的相关资料实际数据，统计研究结果说明，治疗前后两组患者卒中再入院率低于对照组，日常生活能力指标(Barthel指数)恢复状况优于对照组，心功能关键指标和治疗效果较前均有改善，观察组患者心功能指标和治疗总有效率、化验室指标的改善比较显著高于对照组，不良反应(头晕、咳嗽)发生出现情况低于对照组，差异均具有统计学价值和意义(P < 0.05)。结论：采用沙库巴曲缬沙坦治疗射血分数减低心功能不全合并缺血性脑卒中，可比较显著地缓解患者的临床相关症状，并有较好的治疗效果，可使心衰合并缺血性脑中风患者日常生活活动能力得到极大提高，使患者的心功能指标及实验室指标得到有效的改善，降低卒中再入院率，改善患者日常生活活动能力，不良反应发生情况相对较低，具有较高的应用价值，对脑卒中康复可能有一定影响。

Abstract: Objective: To evaluate the efficacy of sacubitril valsartan (ARNI) in the treatment of activities of daily living (ADL) in patients with decreased ejection fraction heart failure complicated with is-chemic stroke. Methods: Observed and analyzed the clinical data of 120 patients with decreased ejection fraction, cardiac insufficiency and ischemic stroke, who were treated in the Second Mu-nicipal Hospital of Weihai, affiliated to Qingdao University from October 2020 to October 2021. According to the treatment difference (whether to take ARNI), 120 patients were divided into control group and observation group, with 60 patients in each group. The 6-month outpatient fol-low-up results of the two groups were collected, record the clinical data of each follow-up visit. The control group received the relevant index results of patients treated with conventional simple treatment, and the observation group received the relevant index results of patients treated with conventional drug treatment plus sacubitril valsartan, and analyzed the readmission rate and ADL recovery (Barthel index) of patients in the two groups, the total effective rate of treatment, specific indexes related to cardiac function before and after treatment, laboratory indexes before and after treatment, the incidence of adverse reactions after treatment. Results: Analyze the actual data of relevant materials received, the statistical results showed that the readmission rate of stroke patients in the two groups before and after treatment was lower than that in the control group, the recovery of daily living ability index (Barthel index) was better than that in the control group, and the cardiac function indicators and treatment effect were improved compared with that before treatment. The cardiac function indicators, the total effective rate of treatment, and the improve-ment of laboratory indicators in the observation group were significantly higher than those in the control group, and the occurrence of adverse reactions was lower than that in the control group, with statistically significant differences (P < 0.05). Conclusion: The treatment of cardiac insuffi-ciency complicated with ischemic stroke with reduced ejection fraction with sacubitril valsartan can significantly relieve the patients’ clinical symptoms, and has a good therapeutic effect, improve the daily living ability of patients with heart failure combined with ischemic stroke, improve the cardiac function indicators and laboratory indicators of patients, reduce the readmission rate of stroke, and improve the daily living ability of patients. The incidence of adverse reactions is relatively low, which has high clinical application value. It may have a certain effect on stroke rehabilitation.