沙库巴曲缬沙坦在维持性血液透析合并慢性心力衰竭患者心室重塑及微炎症状态的影响观察

Effects of sacubitril valsartan sodium on ventricular remodeling and microinflammatory state in maintenance hemodialysis patients with combined chronic heart failure

目的观察沙库巴曲缬沙坦在维持性血液透析合并慢性心力衰竭患者心室重塑及微炎症状态的影响。方法选取2019年9月至2020年3月江苏省江阴市人民医院血液净化中心60例维持性血液透析合并慢性心力衰竭的患者,使用随机数字表法分为对照组和观察组,每组各30例。比较两组的治疗疗效、血清BNP、cTnI、心脏超声指标(LVEF、LAD及LVDD)、心室重塑相关血液指标(MMP及TGF-β1)及微炎症指标(CRP、IL-1β、IL-6)。结果治疗6个月后,观察组的临床总有效率显著高于对照组,差异有统计学意义(P<0.05),治疗前两组的血清BNP、cTnI、心脏超声指标、心室重塑相关血液指标及微炎症指标比较,差异无统计学意义(P>0.05);治疗6个月后,两组的上述指标均持续改善,且观察组治疗前后的改善幅度显著高于对照组,差异有统计学意义(P<0.05)。结论沙库巴曲缬沙坦可显著改善维持性血液透析合并慢性心力衰竭患者的心室重塑及微炎症状态,临床具有较高的应用价值。

Objective To observe the effects of sacubitril valsartan sodium on ventricular remodeling and microinflammatory state in maintenance hemodialysis patients with combined chronic heart failure.Methods A total of 60 maintenance hemodialysis patients with combined chronic heart failure in the blood purification center of our hospital from September 2019 to March 2020 were selected as study subjects.They were divided into the control group and the observation group according to the random number table method,with 30 cases in each group.The treatment efficacy,serum brain natriuretic peptide(BNP),cardiac troponin I(cTnI),cardiac ultrasound indicators(left ventricular ejection fraction[LVEF],left anterior descending coronary artery[LAD],and left ventricular end-diastolic diameter[LVDD]),ventricular remodeling-related blood indicators(matrix metalloproteinase[MMP]and transforming growth factor-β1[TGF-β1])and microinflammatory indicators(C-reactive protein[CRP],interleukin-1β[IL-1β],and interleukin-6[IL-6])were compared between the two groups.Results The total clinical effective rate of the observation group was significantly higher than that of the control group after 6 months of treatment,with statistically significant differences(P<0.05).There were no statistically significant differences between the two groups in serum BNP,cTnI,cardiac ultrasound indicators,ventricular remodeling-related blood indicators and microinflammatory indicators before treatment(P>0.05).The above indicators in both groups were continuously improved after 6 months of treatment,and the improvement level in the observation group was significantly higher than that in the control group,with statistically significant differences(P<0.05).Conclusion Sacubitril valsartan sodium can significantly improve the ventricular remodeling effect and microinflammatory state in maintenance hemodialysis patients with combined chronic heart failure,and has high application value in clinic.