沙库巴曲缬沙坦钠片治疗射血分数降低心衰的效果及安全性

The Efficacy and Safety of Sacubitril Valsartan Sodium Tablets in Treatment of Heart Failure with Reduced Ejection Fraction

目的:评价沙库巴曲缬沙坦钠片治疗射血分数降低心衰(HFrEF)的效果及安全性。方法:选择2019年1-6月本院收治的59例HFrEF患者,随机分为试验组(n=30)和对照组(n=29),试验组使用沙库巴曲缬沙坦钠片治疗,对照组采用传统药物血管紧张素转换酶抑制剂(ACEI)或血管紧张素Ⅱ受体拮抗剂(ARB)治疗,两组患者均接受心衰规范化治疗,3个月后测量两组血浆BNP、左室射血分数(LVEF)、左室短轴缩短分数(LVFS)、6 min步行距离(6MWD)、血肌酐、电解质及血压的变化。结果:与同组治疗前基线水平比较,两组治疗后BNP、收缩压及血肌酐显著降低(P<0.05),而LVEF、LVFS、6MWD显著升高(P<0.05);与对照组比较,试验组治疗后LVEF、LVFS、6MWD显著高(P<0.05),BNP显著低(P<0.05),两组收缩压、舒张压、血肌酐、血钾、血钠水平均无显著性变化(P>0.05)。试验组和对照组均未观察到血管神经性水肿、高钾血症、低血压等不良反应。结论:沙库巴曲缬沙坦钠片能明显改善HFrEF患者心功能,提高运动耐量,安全性高,具有很好的应用前景。

Objective:To observe the efficacy and safety of Sacubitril Valsartan Sodium Tablets in the treatment of heart failure with reduced ejection fraction(HFrEF).Method:A total of 59 patients of HFrEF from January to June 2019 were randomly divided into the experimental group(n=30)and the control group(n=29),the experimental group was treated with Sacubitril Valsartan Sodium Tablets,while the control group was treated with Angiotensin Converting Enzyme Inhibitors(ACEI)or AngiotensinⅡReceptor Blocker(ARB),and two groups of patients received normalized standard of heart failure therapy.After 3 months of treatment,and plasma BNP,left ventricular ejection fraction(LVEF),left ventriculars hortening fraction(LVFS),6 min walking distance(6MWD),renal function,electrolyte and blood pressure change were measured.Result:Compared with the baseline level before treatment in the same group,the level of BNP,systolic blood pressure and serum creatinine in two groups were significantly reduced after treatment(P<0.05),while the level of LVEF,LVFS and 6MWD were significantly increased(P<0.05).Compared with the control group,the level of BNP was significantly reduced after treatment in the experimental group(P<0.05),the level of LVEF,LVFS and 6MWD were significantly increased(P<0.05),and there were no significant changes in the levels of systolic blood pressure,diastolic blood pressure,serum creatinine,serum potassium and serum sodium(P>0.05).No adverse reactions such as hyperkalemia and hypotension were observed in two groups.Conclusion:Sacubitril Valsartan Sodium Tablets is effective and safe in improving the activity tolerance and cardiac function of HFrEF patients,having a good application prospect.