| Objective:To collect the clinical data of patients with Acute ischemic cerebral infarction(AIS)complicated with Chronic heart failure(CHF),and to study the clinical efficacy and prognosis of sacubitril/valsartan on the disease.Methods:Ninety-two patients who were admitted to the First Hospital of Nanchang City between June 2020 and June 2022 with a confirmed diagnosis of acute ischemic stroke combined with chronic heart failure,within 7 days of onset and final completion of1-year follow-up,were collected for inclusion in the study.The patients were divided into the study group and the control group,with 46 cases in each group.The baseline data at admission were collected.The study group and the control group were given AIS basic treatment,and the control group was given standard anti-heart failure drug treatment.The study group was treated with sacubitril/valsartan sodium tablets on this basis.The neurological deficits of each group were recorded at admission,discharge,90 days and 360 days after treatment.NT-pro BNP was recorded on admission and at discharge to evaluate the improvement of cardiac function.To investigate the effect of sacubitril/valsartan on neurological function and cardiac function in patients with AIS complicated with CHF by SPSS26.0 statistical analysis.Results:1.The NIHSS scores of the study group and the control group were significantly lower than those before treatment(P < 0.05).However,there was no significant difference in NIHSS score between the two groups at admission and at discharge(P>0.05).2.At discharge and 90 days after treatment,the MRS Scores of the two groups decreased(P < 0.05),and 90 days after treatment,the MRS Score of the study group decreased more significantly than that of the control group,and the difference was statistically significant(P < 0.05).There was no significant difference in MRS Between the two groups at 360 days and 90 days after treatment(P>0.05).3.In the study group,the BI score at discharge was significantly higher than that at admission,at 90 days after treatment,and at 360 days after treatment,compared with that at 90 days after treatment(P < 0.05).The BI score of the control group at discharge was significantly higher than that at admission(P < 0.05).In the control group,there was no significant difference in BI score between 90 days after treatment and discharge,and between 360 days after treatment and 90 days after treatment(P>0.05).4.The NT-pro BNP index in the study group and the control group decreased compared with that before treatment(P < 0.05).The improvement of NT-pro BNP level at discharge in the study group was more obvious than that in the control group,and the difference was statistically significant(P<0.05).5.Taking the prognosis at 90 days after treatment as the dependent variable and the indicators affecting prognosis in univariate analysis as the independent variables,binary Logistic regression analysis was performed.The results showed that the independent risk factors affecting the prognosis at 90 days after treatment of acute ischemic stroke complicated with chronic heart failure were as follows: NIHSS score at admission(OR 1.425,95%CI 1.13-1.79,P=0.003),systolic blood pressure(OR1.086,95%CI 1.02-1.16,P=0.015),diastolic blood pressure(OR 0.887,95%CI0.81-0.97,P=0.015),P=0.012),cardiac functional class(OR 0.078,95%CI 0.01-0.76,P=0.028),and sacubitril-valsartan treatment(OR 0.152,95%CI 0.03-0.94,P=0.042).Conclusions:1.Sacubitril/valsartan can improve the long-term quality of life and cardiac function in patients with acute ischemic stroke complicated with chronic heart failure.2.Sacubitril/valsartan for 90 days has the best prognosis in improving the recovery of neurological function of patients.3.The higher the cardiac function grade,the greater the risk of poor prognosis;A better prognosis is more likely with sacubitril-valsartan. |
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