沙库巴曲缬沙坦在心力衰竭患者中的滴定方法探讨

Study on the titration method of sacubitril valsartan in patients with heart failure

目的对沙库巴曲缬沙坦在我国心力衰竭患者中的滴定方法进行探讨。方法选取泰安市中心医院2019年6月—2020年6月于心内科住院的慢性心力衰竭(CHF)患者97例,按照随机数表法分为研究组及对照组,其中研究组50例,对照组47例;对照组按照沙库巴曲缬沙坦钠片(北京诺华制药公司,J20171054)说明书对沙库巴曲缬沙坦进行滴定。研究组患者按照研究所指定的滴定方法进行滴定。对滴定过程中的相关指标进行分析。结果研究组所能达到200 mg bid的推荐剂量的患者数量、最终所服用药物剂量与对照组相比较无明显统计学差异(P>0.05),而研究组达到200 mg bid所需要的时间为与对照组相比具有统计学差异(P<0.05);研究组在给予患者滴定期间出现低血压或症状性低血压的患者共7例,高血钾患者3例,肌酐升高>50%的患者共4例,再入院患者2例;对照组滴定期间出现低血压或症状性低血压的患者共5例,高血钾患者2例,肌酐升高>50%的患者共3例,再入院患者4例,将2组患者指标比较,差异均无统计学意义(P>0.05)。结论该研究中所采用的滴定方法安全、有效,可以使患者尽快达到最大靶剂量或耐受剂量。

Objective Combined with the current situation of our country,we discussed the titrimetric method of valsartan in patients with heart failure.Method A total of 97 patients with CHF who were admitted to the Department of Cardiology from June 2019 to June 2020 in Tai'an city center hospital were divided into two groups according to the table of random numbers.There were 50 patients in the experimental group and 47 in the control group.The control group was titrated with valsartan according to the specification of valsartan tablets(Novartis,Beijing,J20171054).The patients in the test group were titrated according to the titrimetric method specified in this study.The related indexes in the titration process were analyzed.Results There was no significant difference in the number of patients who received the recommended dose of 200 mg bid and the final dose of the drug in the trial group compared with the control group(P>0.05),the time required to 200 mg bid in the test group was statistically different from that in the control group(P<0.05).There were 7 cases of hypotension or symptomatic hypotension,3 cases of hyperkalemia,4 cases of creatinine elevation>50%,and 2 cases of readmission;there were 5 cases of hypotension or symptomatic hypotension,2 cases of hyperkalemia,3 cases of creatinine elevation>50%and 4 cases of readmission;there was no significant difference between the two groups(P>0.05).Conclusion The titrimetric method used in this study is safe and effective,and can enable patients to reach the maximum target dose or tolerance dose as soon as possible.