沙库巴曲缬沙坦联合新活素治疗高原地区慢性心力衰竭患者的临床疗效分析

CLINICAL EFFICACY OF SACUBITRIL/VALSARTAN COMBINED WITH BRAIN NATRIURETIC PEPTIDE IN THE TREATMENT OF PATIENTS WITH CHRONIC HEART FAILURE IN HIGH ALTITUDE AREAS

目的研究沙库巴曲缬沙坦和新活素联合用药对高原地区慢性心力衰竭患者的治疗效果。方法选取2018年1月—2019年6月在雅安市人民医院治疗的失代偿性心力衰竭患者92例作为研究对象,随机数字表法分为对照组和观察组,对照组在常规治疗的基础上给予新活素治疗,观察组在对照组的基础上给予沙库巴曲缬沙坦治疗,比较二组治疗效果,血压、血清生化指标和心功能指数,并记录对药物不良发生率和疾病复发率。结果治疗后接受联合药物治疗的观察组总有效率为91.30%,显著高于对照组的76.09%(P<0.05)。治疗前二组患者血压、eGFR、血清钾及NT-proBNP水平差异均无统计学意义(均P>0.05),治疗后二组患者的收缩压,NT-proBNP的水平显著降低,eGFR水平显著提高(均P<0.05)。与对照组比较,联合用药的观察组舒张压和血清NT-proBNP的水平显著降低,eGFR水平显著提高(均P<0.05)。治疗后二组患者的LVEDd、LVESd和LVEF均有显著改善(P <0.05),且联合用药的观察组显著优于对照组(P <0.05)。结论沙库巴曲缬沙坦和新活素联合用药可显著改善高原地区失代偿性心力衰竭患者病情,为高原地区失代偿性心力衰竭的用药治疗提供一定的参考。

Objective To study the therapeutic effect of combination of Sacubitril/valsartanand Brain natriuretic peptideon patients with chronic heart failure in high altitude areas.Methods Ninety two patients with decompensated heart failure who were treated in Ya’an people’s Hospital from January 2018 to June 2019 were selected and randomly divided into control group and observation group.The control group was given neoactivin treatment on the basis of conventional treatment, and the observation group was given sakubatravalsartan on the basis of the control group.The treatment effect, blood pressure, serum biochemical indexes and cardiac function of the two groups were compared.The incidence of adverse drug reactions and disease recurrence rate were recorded.Results After treatment, the total effective rate of the observation group was 91.30%,significantly higher than 76.09% of the control group(P<0.05).Before treatment, there was no significant difference in blood pressure, EGFR,serum potassium and NT proBNP levels between the two groups(P>0.05).After treatment, systolic blood pressure and NT proBNP levels of the two groups were significantly decreased, and EGFR levels were significantly increased(P<0.05).Compared with the control group, the levels of diastolic blood pressure and serum NT proBNP were significantly decreased, and the EGFR level was significantly increased(P<0.05).After treatment, LVEDd, LVESd and LVEF of the two groups were significantly improved(P<0.05),and the observation group was significantly better than the control group(P<0.05).Conclusion The combination of salkubatrazartan and neoactivin can significantly improve the condition of patients with decompensated heart failure, which is worthy of clinical promotion.