沙库巴曲缬沙坦辅助治疗对慢性心力衰竭患者心功能及NT-proBNP、AngⅡ和醛固酮水平的影响

Effect of Sacubitril Valsartan on Cardiac Function and the Levels of NT-proBNP,AngⅡand ALD in Patients with CHF

目的:探究沙库巴曲缬沙坦辅助治疗对慢性心力衰竭(CHF)患者心功能及N-端脑利钠肽前体(NT-proBNP)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)水平的影响。方法:选取2018年7月~2020年1月本院收治的CHF患者120例作为研究对象,采用随机数字表法分为观察组和对照组,每组60例。对照组采取常规对症治疗,观察组在对照组的基础上联合使用沙库巴曲缬沙坦辅助治疗。规律用药3个月后,分析两组临床疗效、心功能每搏输出量(SV)、左心室舒张末期容积(LVEDV)、左心室后壁厚度(LVPW)、左心室射血分数(LVEF):、心室重构指标左心室质量指数(LVMI)、左室壁应力(MWS)、左室重构指数(LVRI):及血清中NT-proBNP、AngⅡ和ALD表达水平,并记录治疗过程中的不良反应情况。结果:观察组治疗总有效率(91.67%)高于对照组(73.33%,P<0.05);观察组SV、LVEF和LVRI高于对照组(P<0.05);LVEDV、LVPW、LVMI和MWS低于对照组(P<0.05);观察组血清中NT-proBNP、AngⅡ和ALD水平低于对照组(P<0.05)。两组不良反应发生率比较无统计学差异(P>0.05)。结论:沙库巴曲缬沙坦辅助治疗对CHF患者疗效较好,能改善患者心功能,逆转心室重构,减少血清NT-proBNP、AngⅡ、ALD的分泌。

Objective:To study the effects of sacubitril valsartan on cardiac function and the levels of N-terminal pro-brain natriuretic peptide(NT-proBNP),angiotensinⅡ(AngⅡ)and aldosterone(ALD)in patients with chronic heart failure(CHF).Methods:A total of 120 patients with CHF from July 2018 to January 2020 in our hospital were selected as research subjects.The patients were divided into observation group and control group by random number table method,with 60 cases in each group.The control group was treated with routine symptomatic treatment,and the observation group was treated with sacubitril valsartan on the basis of the control group.After regular treatment for 3 months,the clinical efficacy,cardiac function stroke volume(SV),left ventricular end-diastolic volume(LVEDV),left ventricular posterior wall thickness(LVPW),left ventricular ejection fraction(LVEF):,ventricular remodeling status left ventricular mass index(LVMI),left ventricular wall stress(MWS),left ventricular remodeling index(LVRI):and the expression levels of NT-proBNP,AngⅡand ALD in serum between two groups were analyzed.The adverse reactions during the treatment were recorded.Results:The total effective rate of the observation group was 91.67%,which was significantly higher than that of the control group(73.33%,P<0.05).The levels of SV,LVEF and LVRI in the observation group were higher than those in the control group(P<0.05).LVEDV,LVPW,LVMI and MWS in the observation group were lower than those in the control group(P<0.05).The serum levels of NT-proBNP,AngⅡand ALD in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion:Sacubitril valsartan adjuvant therapy in patients with chronic heart failure has good efficacy,which can improve cardiac function of patients,reverse ventricular remodeling,and reduce the secretion of serum NT-probNP,AngⅡand ALD.