沙库巴曲缬沙坦治疗左室射血分数降低的心力衰竭的临床效果

Clinical effect of Sacubitril Valsartan in treatment of heart failure with reduced left ventricular ejection fraction

目的探讨沙库巴曲缬沙坦治疗左室射血分数(LVEF)降低的心力衰竭的临床效果。方法选择2019年1月~2020年1月萍乡市人民医院收治的80例LVEF降低的心力衰竭患者作为研究对象,采用随机数字表法分为两组,每组各40例。对照组给予常规抗心衰治疗,观察组给予沙库巴曲缬沙坦代替对照组血管紧张素转化酶抑制剂和血管紧张素Ⅱ受体拮抗剂(ACEI/ARB)治疗。比较两组治疗前、治疗3个月后神经内分泌系统血清含量[去甲肾上腺素(NE)、醛固酮、血管紧张素Ⅱ(AngⅡ)、血浆氨基末端脑钠肽前体(NT-proBNP)],心脏结构[左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、LVEF]以及明尼苏达心力衰竭生活质量问卷表(MHFQL)评分。结果两组治疗前神经内分泌系统血清含量、心脏结构、生活质量比较,差异无统计学意义(P>0.05);治疗3个月后两组NE、醛固酮、AngⅡ、LVESD、LVEDD、NT-proBNP、MHFQL评分低于治疗前,LVEF高于治疗前,且观察组NE、醛固酮、AngⅡ、LVESD、LVEDD、NT-proBNP、MHFQL评分低于对照组,LVEF高于对照组,差异有统计学意义(P<0.05)。结论沙库巴曲缬沙坦治疗LVEF降低的心力衰竭能够抑制神经内分泌的过度激活,预防和逆转心血管重构,增加LVEF,提高生活质量。

Objective To explore the clinical effect of Sacubitril Valsartan in treatment of heart failure with reduced left ventricular ejection fraction(LVEF).Methods A total of 80 heart failure patients with reduced left ventricular ejection fraction who were admitted in Pingxiang People′s Hospital from January 2019 to January 2020 were selected as the research subjects and divided into two groups according to random number table method,with 40 cases in each group.The control group was received routine anti-heart failure treatment,and the observation group was treated with Sacubitril Valsartan instead of angiotensin converting enzyme inhibitor and angiotensinⅡreceptor blocker(ACEI/ARB).Serum levels of the neuroendocrine system(norepinephrine[NE],aldosterone,angiotensinⅡ[AngⅡ],N-terminal pro-brain natriuretic peptide[NT-proBNP]),cardiac structure(left ventricular end-systolic dimension[LVESD],left ventricular end-diastolic dimension[LVEDD],LVEF)and the Minnesota heart failure quality of life(MHFQL)score were compared between the two groups before treatment and after treatment for 3 months.Results There were no statistical differences in the serum content of neuroendocrine system,cardiac structure,and quality of life between the two groups before treatment(P>0.05).The NE,aldosterone,AngⅡ,LVESD,LVEDD,NT-proBNP,MHFQL scores in the two groups after treatment for 3 months were higher than those before treatment,and the LVEF was lower than that before treatment;the NE,aldosterone,AngⅡ,LVESD,LVEDD,NT-proBNP and MHFQL scores in the observation group were lower than those in the control group,and the LVEF in the observation group was higher than that in the control group,and the differences were statistically significant(P<0.05).Conclusion Sacubitril valsartan in treatment of heart failure patients with reduced LVEF can inhibit over-activation of neuroendocrine,prevent and reverse cardiovascular remodeling,increase LVEF,and improve quality of life.