沙库巴曲缬沙坦钠对顽固性心力衰竭患者血清N末端脑钠肽前体水平及心功能的影响

Effects of Sacubitril and Valsartan Sodium on Serum NT-ProBNP Levels and Cardiac Function Indexes in Patients with Refractory Heart Failure

目的探讨沙库巴曲缬沙坦钠对顽固性心力衰竭(HF)患者血清N末端脑钠肽前体(NT-proBNP)水平及心功能指标的影响。方法选取2017年1月至2019年12月就诊于武汉科技大学附属汉阳医院的102例顽固性HF患者作为研究对象,按随机数字表法分为对照组与观察组,各51例。两组予以常规抗HF治疗,对照组在此基础上口服贝那普利治疗,观察组加用沙库巴曲缬沙坦钠治疗。比较两组血清学指标、心功能指标、6 min步行距离和不良反应发生情况。结果观察组NT-pro BNP、醛固酮(ALD)、细胞间黏附分子-1(ICAM-1)水平为(489.63±52.17)ng/L、(39.52±4.27)ng/L、(30.23±4.05)ng/L,低于对照组,差异有统计学意义(P<0.05);观察组左室射血分数(LVEF)高于对照组,左室舒张末期内径(LVEDD)及左室收缩末期内径(LVESD)低于对照组,差异有统计学意义(P<0.05);观察组6 min步行距离长于对照组,差异有统计学意义(P<0.05);两组未发生严重不良反应。结论沙库巴曲缬沙坦钠治疗顽固性HF可降低NT-pro BNP、ALD、ICAM-1水平,减轻心肌组织损伤,促进心功能恢复,增强患者活动耐量,安全可靠。

Objective To investigate the clinical effect of sacubitril and valsartan sodium in the treatment of patients with refractory heart failure(HF) and its influence on cardiac function. Methods A total of 102 patients with refractory HF who were admitted to Hanyang Hospital, Wuhan University of Science and Technology from January 2017 to December 2019 were selected as the research objects and were randomly divided into a control group and an observation group with 51 cases in each group. Both groups were treated with conventional anti-HF treatment, and the control group was treated with benazepril orally plus conventional anti-HF treatment. The observation group was treated with sacubitril and valsartan sodium. Serological indexes, cardiac function indexes, 6-min walking distance and occurrence of adverse reactions were compared between the 2 groups. Results The levels of NT-proBNP, ALD and ICAM-1 in the observation group were(489.63±52.17) pg/mL,(39.52±4.27) pg/mL,(30.23±4.05) ng/L, which were lower than those of the control group, and the difference was statistically significant.(P<0.05);the left ventricular ejection fraction(LVEF) of the observation group was higher than that of the control group, and the left ventricular end-diastolic diameter(LVEDD) and left ventricular end-systolic diameter(LVESD) were lower than those of the control group, and the difference was statistically significant(P<0.05);the 6-minute walking distance was longer than that of the control group, and the difference was statistically significant(P<0.05);no serious adverse reactions occurred in the 2 groups. Conclusion The treatment of refractory HF with sacubitril and valsartan sodium can reduce the levels of NT-proBNP, ALD and ICAM-1, reduce myocardial tissue damage, promote the recovery of cardiac function, and enhance the patient’s exercise tolerance, which is safe and reliable.