沙库巴曲缬沙坦治疗老年射血分数保留心力衰竭的效果及对炎性因子和生活质量的影响

Efficacy of Sacubitril/Valsartan in Treatment of Elderly Patients with Heart Failure Preserved by Ejection Fraction and Its Effects on Inflammatory Factors and Quality of Life

目的探讨沙库巴曲缬沙坦对老年射血分数保留心力衰竭(HFpEF)患者心功能、炎性因子、生活质量的改善作用。方法连续性纳入2017年10月—2020年3月诊治的368例老年HFpEF患者,按治疗方法分为研究组和对照组,每组184例。两组均给予常规治疗,对照组、研究组分别在常规治疗的基础上给予缬沙坦、沙库巴曲缬沙坦,连续治疗10周。比较两组治疗前后左心室射血分数(LVEF)、左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)、N末端脑钠肽前体(NT-proBNP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、6 min步行距离及明尼苏达心力衰竭生活质量问卷(MLHFQ)评分,并观察两组的临床疗效和不良反应发生情况。结果治疗后,两组LVEF和6 min步行距离均较治疗前升高,LVESV、LVEDV、NT-proBNP、TNF-α、IL-6、hs-CRP和MLHFQ评分均较治疗前降低,且研究组上述指标的变化程度均较对照组更显著(P<0.05)。研究组总有效率显著高于对照组(P<0.01)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论沙库巴曲缬沙坦能提高老年HFpEF患者心功能,减轻炎症反应,提高生活质量,且具有较好的安全性。

Objective To explore improvement effects of Sacubitril/Valsartan on cardiac function,inflammatory factors and quality of life in treatment of elderly patients with heart failure preserved by ejection fraction(HFpEF).Methods A total of 368 HFpEF patients who had diagnosed and treated during October 2017 and March 2020 were consecutively enrolled,and the patients were divided into research group(n=184)and control group(n=184)according to different treatment methods.Both groups were given conventional treatments.Control and research groups were respectively given Valsartan and Sacubitril/Valsartan on the basis of conventional treatments for consecutive 10 weeks.Values of left ventricular ejection fraction(LVEF),left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV),N-terminal pro-brain natriuretic peptide(NT-proBNP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),hypersensitive C-reactive protein(hs-CRP),6-min walking distance,and Minnesota Living with Heart Failure Questionnaire(MLHFQ)score before and after treatment were compared between two groups.Clinical efficacy and conditions of adverse reactions were observed in two groups.Results After treatment,values of LVEF and 6-min walking distance were significantly higher,while values of LVESV,LVEDV,NT-proBNP,TNF-α,IL-6,hs-CRP and MLHFQ scores were significantly lower than those before treatment in two groups,and changed degrees of the above indicators in research group were more significant than those in control group(P<0.05).The total effective rate in research group was significantly higher than that in control group(P<0.01).There was no significant difference in incidence rate of adverse reactions between two groups(P>0.05).Conclusion Sacubitril/Valsartan may improve heart function,reduce inflammatory reaction and improve quality of life of elderly patients with HFpEF with good safety.