沙库巴曲缬沙坦钠片对慢性心力衰竭患者心功能及脑钠肽、sICAM-1、sCD40L水平的影响

Effects of sacubitril/valsartan sodium tablets on cardiac function and levels of BNP,sICAM-1and sCD40L in patients with chronic heart failure

目的观察沙库巴曲缬沙坦钠片对慢性心力衰竭患者心功能及脑钠肽(BNP)、可溶性细胞间黏附分子1(sICAM-1)、可溶性白细胞分化抗原40配体(sCD40L)水平的影响。方法选取2019年1月—2020年1月邯郸市第一医院心内科收治的108例慢性心力衰竭患者,采用随机数字表法分为对照组和观察组,每组54例。在传统抗心力衰竭治疗基础上,对照组患者给予缬沙坦片治疗,观察组患者给予沙库巴曲缬沙坦钠片治疗,2组患者均治疗3个月。比较2组患者临床疗效,治疗前后心功能指标[左心室射血分数(LVEF)、左心室收缩末期容积(LVESV)及左心室舒张末期容积(LVEDV)]、6 min步行距离及血清BNP、sICM-1和sCD40L水平,并记录2组患者治疗期间不良反应发生率。结果观察组患者治疗总有效率为88.9%,高于对照组的72.2%(χ^(2)=4.788,P=0.029)。治疗后,2组患者LVEF高于治疗前,LVESV、LVEDV分别小于治疗前,6 min步行距离长于治疗前(P<0.05),且观察组患者LVEF高于对照组,LVESV、LVEDV小于对照组,6 min步行距离长于对照组(P<0.01)。治疗后,2组患者血清BNP、sICAM-1、sCD40L水平低于治疗前,且观察组低于对照组(P<0.01)。2组患者不良反应发生率比较,差异无统计学意义(χ^(2)=0.153,P=0.696)。结论沙库巴曲缬沙坦钠片治疗慢性心力衰竭可有效提高其临床疗效,改善心功能,降低血清BNP、sICAM-1、sCD40L水平,且安全性较高。

Objective To investigate the effects of sacubitril/valsartan sodium tablets on cardiac function and levels of brain natriuretic peptide(BNP),soluble intercellular adhesion molecule-1(sICAM-1) and soluble CD40 ligand in patients with chronic heart failure.Methods A total of 108 patients with chronic heart failure treated in the Department of Cardiology of the First Hospital of Handan from January 2019 to January 2020 were selected and randomly divided into observation group and control group by random number table method,with 54 cases in each group.On the basis of traditional anti heart failure treatment,the patients in the control group were treated with valsartan tablets,and the patients in the observation group were treated with sacubitril/valsartan sodium tablets.Both groups were treated for 3 months.The clinical efficacy,cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end systolic volume(LVESV)and left ventricular end diastolic volume(LVEDV)],6 min walking distance and serum BNP,sICAM-1,sCD40L levels were compared between the two groups before and after treatment,and the incidence of adverse reactions during treatment was recorded.Results The total effective rate in the observation group was 88.9%,which was higher than 72.2%in the control group(χ^(2)=4.788,P=0.029).After treatment,LVEF of the two groups was higher than that before treatment,LVESV and LVEDV were lower than those before treatment,and the 6 min walking distance was longer than that before treatment(P<0.05).After treatment,LVEF in the observation group was higher than that in the control group,LVESV and LVEDV were lower than those in the control group,and the 6 min walking distance was longer than that in the control group(P<0.01).After treatment,the serum levels of BNP,sICAM-1 and sCD40L in the two groups were lower than those before treatment,and the serum levels of BNP,sICAM-1 and sCD40L in the observation group were lower than those in the control group(P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups(χ^(2)=0.153,P=0.696).Conclusion Sacubitril/valsartan sodium tablets can effectively improve clinical efficacy and cardiac function of chronic heart failure,reduce the serum levels of BNP,sICAM-1 and sCD40L,and has high safety.