沙库巴曲缬沙坦对射血分数中间值心力衰竭患者心功能及近期预后的影响

Effects of shakubatrovalsartan on cardiac function and near-term prognosis in patients with median ejection fraction heart failure

目的研究射血分数中间值心力衰竭患者治疗中沙库巴曲缬沙坦对其心功能及近期预后的影响。方法采用回顾性分析方法,研究对象为2019年1月至2020年12月华中科技大学同济医学院附属梨园医院收治的105例射血分数中间值心力衰竭患者。根据治疗方法不同分为对照组(52例)与研究组(53例),对照组行常规抗心力衰竭治疗,研究组将常规抗心力衰竭方案内依那普利替换为沙库巴曲缬沙坦。比较2组患者治疗前、治疗后3个月心功能指标(左室射血分数、左心室舒张末期内径、舒张期室间隔厚度及左心房前后径)水平、生活质量评分、治疗总有效率和心脏不良事件(心力衰竭恶化、恶性心律失常、心源性死亡)发生率。结果治疗前,2组患者心功能指标水平、生活质量评分比较,差异均无统计学意义(P>0.05)。治疗后3个月,研究组左室射血分数、总有效率为(55.37±4.06)%、96.23%,明显高于对照组[(51.05±3.94)%、78.85%],左心室舒张末期内径、舒张期室间隔厚度、左心房前后径、生活质量评分及不良心脏事件发生率分别为(47.53±4.31) mm、(8.98±0.86) mm、(34.13±3.15) mm、(62.32±6.43)分、5.66%,明显低于对照组[(52.27±5.13) mm、(10.32±1.07) mm、(36.77±3.44) mm、(77.24±7.16)分、23.08%],差异均有统计学意义(P<0.05)。结论射血分数中间值心力衰竭患者治疗中沙库巴曲缬沙坦的疗效显著,可改善患者心功能及生活质量,并减少心脏不良事件发生风险。

Objective To investigate the effect of shakubactrevalsartan on cardiac function and short-term prognosis in patients with heart failure with median ejection fraction. Methods Using a retrospective analysis method,105 patients with heart failure with median ejection fraction admitted to Liyuan Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2019 to December2020 were selected as the research objects,and they were divided into control group(52 cases) and study group(53 cases) according to different treatment methods. The control group received conventional heart failure treatment,and the study group replaced enalapril with shakubactrivalsartan in the conventional heart failure regimen. Cardiac function indexes(left ventricular ejection fraction,left ventricular end-diastolic diameter,diastolic interventricular septal thickness and left atrial anteroposterior diameter),quality of life score,total response rate after treatment,and incidence of adverse cardiac events(worsening of heart failure,malignant arrhythmias and cardiogenic death) were compared between the 2 groups before and after 3 months treatment. Resluts Before treatment,there were no significant differences in heart function indexes and quality of life scores between 2 groups(P>0.05). Three months after treatment,the left ventricular ejection fraction and total effective rate in the study group were(55. 37 ± 4. 06) % and 96. 23%,which were significantly higher than those in the control group [(51. 05 ± 3. 94) %,78. 85%]. The left ventricular end-diastolic diameter,diastolic ventricular septal thickness,left atrial anterior and posterior diameter,quality of life score,and incidence of adverse cardiac events were(47. 53 ± 4. 31) mm,(8. 98 ± 0. 86) mm,(34. 13 ± 3. 15) mm,(62. 32 ± 6. 43) points,5. 66%,respectively,which were significantly lower than those in the control group [(52. 27 ± 5. 13) mm,(10. 32 ± 1. 07) mm,(36. 77 ± 3. 44) mm,(77. 24 ± 7. 16) points,23. 08% ],the differences were statistically significant(P<0.05). Conslusion Shakubactrevalsartan has a significant efficacy in treating patients with median ejection fraction heart failure,improving cardiac function and quality of life,and reducing the risk of adverse cardiac events.