沙库巴曲缬沙坦在心力衰竭中的应用效果及对血液流变学的影响研究

Application Effect of Sacubitril/Valsartan in Heart Failure and Its Influence on Hemorheology

目的:探讨沙库巴曲缬沙坦在心力衰竭中的应用效果及对血液流变学的影响。方法:选择2019年6月-2021年2月萍乡市第二人民医院收治的心力衰竭患者108例为研究对象,随机数字表法将患者分为两组,每组54例。对照组采用厄贝沙坦治疗,观察组采用沙库巴曲缬沙坦治疗。用药4周后比较两组效果、心室重塑、6分钟步行试验(6MWT)、血液流变学、不良反应发生率。结果:用药4周后,两组心室重塑和6MWT较用药前均改善,且观察组IVST、LVPWT均低于对照组,LVMI和6MWT均高于对照组,差异均有统计学意义(P<0.05)。用药4周后,两组血液流变学指标较用药前均降低,且观察组全血黏度、血浆黏度、血细胞比容、纤维蛋白原及全血还原黏度水平均低于对照组,差异均有统计学意义(P<0.05)。两组用药期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论:沙库巴曲缬沙坦应用于心力衰竭患者中有助于改善心室重塑,提高患者运动耐受性,亦可改善血液流变学水平,且未增加不良反应发生率,值得推广应用。

Objective:To investigate the application effect of Sacubitril/Valsartan in heart failure and its influence on hemorheology.Method:A total of 108 patients with heart failure treated in Pingxiang Second People’s Hospital from June 2019 to February 2021 were selected as the study objects and randomly divided into two groups,54 cases in each group.The control group was treated with Irbesartan,while the observation group was treated with Sacubitril/Valsartan.After 4 weeks treatment,the ventricular remodeling,6 minute walking test (6MWT),hemorheology and adverse reaction rate were compared between two groups.Result:After 4 weeks of treatment,the ventricular remodeling and 6MWT of two groups were improved compared with those before treatment,and the IVST and LVPWT of the observation group were lower than those of the control group,and the LVMI and 6MWT were higher than those of the control group,the differences were statistically significant (P<0.05).After 4 weeks of treatment,the hemorheological indexes of two groups were lower than those before treatment,and the whole blood viscosity,plasma viscosity,hematocrit,fibrinogen and whole blood reduced viscosity levels of the observation group were lower than those of the control group,the differences were statistically significant (P<0.05).There was no significant difference in the incidence of adverse reactions between two groups during treatment (P>0.05).Conclusion:Sacubitril/Valsartan Sodium Tablets can improve ventricular remodeling and exercise tolerance in patients with heart failure,and can also improve hemorheology and without increasing the incidence of adverse reactions,which is worthy of popularization and application.