〔摘 要〕 目的：探讨沙库巴曲缬沙坦联合整合式管理干预在心力衰竭合并肾功能不全患者临床治疗中的价值。 方法：选取瑞金市人民医院 2021 年 1 月至 2021 年 12 月收治的 100 例心力衰竭合并肾功能不全患者，随机分为对照组和观察组，各 50 例。对照组患者在常规管理基础上使用沙库巴曲缬沙坦进行治疗，观察组患者在对照组基础上联合整合式管理进行治疗。 比较两组患者心功能、临床症状改善情况、生活质量、临床指标。 结果：治疗后，两组患者心功能检测项均有改善，观察组 患者心率、左心室收缩末期内径均低于对照组，且观察组左心室射血分数高于对照组，差异均具有统计学意义（P ＜ 0.05）。 观察组患者各项临床症状改善占比均高于对照组，差异具有统计学意义（P ＜ 0.05）。治疗后，两组患者明尼苏达州心功 能不全生命质量量表（MLHFQ）评分均降低，且观察组低于对照组，差异具有统计学意义（P ＜ 0.05）。治疗后，观察组 患者血肌酐清除率、肾小球滤过率均高于对照组，N 末端脑钠肽前体水平低于对照组，差异均具有统计学意义（P ＜ 0.05）。 结论：沙库巴曲缬沙坦联合整合式管理干预，能够提高患者治疗配合度，同时进一步改善了患者的预后及生活质量。
〔Abstract〕 Objective To explore the value of integrated management intervention combined with sacubitril valsartan in the clinical treatment of patients with heart failure and renal insufficiency. Methods 100 patients with heart failure and renal insufficiency admitted to People's Hospital of Ruijin City from January 2021 to December 2021 were randomly divided into a control group and an observation group, with 50 patients in each group. The control group patients were treated with sacubitril valsartan on the basis of routine management, while the observation group patients were treated with integrated management on the basis of the control group. The cardiac function, clinical symptom improvement, quality of life, and clinical indicators between the two groups of patients were compared. Results After treatment, the levels of cardiac function testing improved in both groups of patients. The heart rate and left ventricular end systolic diameter of the observation group were lower than those of the control group, and the left ventricular ejection fraction of the observation group was higher than that of the control group, the differences were statistically significant (P < 0.05). The proportion of patients with improved clinical symptoms in the observation group was higher than that in the control group, and the difference was statistically significant (P < 0.05). After treatment, the Minnesota living with heart failure questionnaire (MLHFQ) scores of both groups of patients decreased, and the score of the observation group was lower than that in the control group, with statistical significance (P < 0.05). After treatment, the blood creatinine clearance rate and glomerular filtration rate in the observation group were higher than those in the control group, and the level of N-terminal pro-brain natriuretic peptide in the observation group was lower than that in the control group, the differences were statistically significant (P < 0.05). Conclusion The combination of sacubitril valsartan and integrated management intervention can improve the patient's treatment compatibility, while further improving the patient's prognosis and quality of life.