不同剂量沙库巴曲缬沙坦联合他汀类药物治疗心房颤动合并射血分数保留心力衰竭的效果

Clinical Efficacies of Different Doses of Sacubatrovalsartan Combined with Statins in Treatment of Patients with Atrial Fibrillation Complicated by Heart Failure with Preserved Ejection Fraction

目的研究不同剂量沙库巴曲缬沙坦联合他汀类药物治疗心房颤动(房颤)合并射血分数保留心力衰竭(HFpEF)的效果。方法选取我院130例房颤合并HFpEF,据治疗剂量的不同均分为大剂量组与小剂量组。2组均接受他汀类药物治疗,另大剂量组予沙库巴曲缬沙坦100 mg、每日2次治疗,小剂量组予沙库巴曲缬沙坦50 mg、每日2次治疗,均治疗12周。比较2组疗效,治疗前后心脏指数(CI)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、心率(HR)、左心房内径、左心室容积指数(LAVI)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、去甲肾上腺素(NE)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)水平,以及不良反应发生情况。结果治疗后大剂量组总有效率显著高于小剂量组(P<0.05)。治疗后2组CI、LVEF显著高于治疗前,LVEDD、HR、IL-6、TNF-α、hs-CRP、NE、AngⅡ、ALD显著低于治疗前,且大剂量组上述指标升高及降低程度大于小剂量组(P<0.05,P<0.01)。2组治疗后不良反应比较差异无统计学意义(P>0.05)。结论大剂量沙库巴曲缬沙坦联合他汀类药物治疗房颤合并HFpEF效果优于小剂量沙库巴曲缬沙坦治疗,并有利于改善心功能、降低炎性因子及神经内分泌激素水平,且安全性高。

Objective To study clinical efficacies of different doses of Sacubatrovalsartan combined with Statins in treatment of patients with atrial fibrillation(AF)complicated by heart failure with preserved ejection fraction(HFpEF).Methods A total of 130 patients with AF complicated by HFpEF were selected and divided into high-dose group and low-dose group according to different therapeutic doses.Both groups were treated with Statins.The high-dose group was given 100 mg Sacubatrovalsartan twice a day,while the low-dose group was treated with 50 mg Sacubatrovalsartan twice a day,and both groups were treated for 12 weeks.Clinical efficacy,levels of cardiac index(CI),left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),heart rate(HR),left atrial diameter,left ventricular Volume index(LAVI),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP),norepinephrine(NE),angiotensinⅡ(AngⅡ)and aldosterone(ALD)before and after treatment as well as incidence rate of adverse reactions were compared between two groups.Results After treatment,the total effective rate in high-dose group was significantly higher than that in low-dose group(P<0.05).After treatment,CI and LVEF levels were significantly higher,while LVEDD,HR,IL-6 and TNF-α,hs-CRP,NE,AngⅡand ALD were significantly lower than those before treatment in two groups,and the increased and decreased degrees of the above indicators in high-dose group were greater than those in low-dose group(P<0.05,P<0.01).There was no significant difference in incidence rate of adverse reactions between two groups(P>0.05).Conclusion Clinical efficacy of high-dose Sacubatrovalsartan combined with Statins in treatment of patients with AF complicated by HFpEF is better than that by low-dose Sacubatrovalsartan,which is beneficial to improvement of cardiac function and reduction of levels of inflammatory factors and neuroendocrine hormones with good safety.