沙库巴曲缬沙坦治疗射血分数保留心力衰竭的临床疗效观察

Curative effect of sakubatril-valsartan on heart failure with preserved ejection fraction

目的观察沙库巴曲缬沙坦治疗射血分数保留心力衰竭(HFpEF)的临床疗效和对无创血流动力学参数的影响。方法148例HFpEF患者随机分为对照组和观察组,每组各74例,对照组采用ACEI/ARB治疗,观察组采用沙库巴曲缬沙坦治疗。比较两组患者的临床疗效、6 min步行距离(6MWD),超声心动图[左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左室射血分数(LVEF)]和无创血流动力学检查[心率(HR)、心输出量(CO)、心脏指数(CI)、每搏输出量(SV)、每搏指数(SI)],记录不良反应。结果观察组总有效率为89.2%,高于对照组的73.0%(P<0.05)。治疗后,两组LVEF、6MWD、CO、CI、SV、SI均升高,HR降低(P<0.05)。与对照组比较,观察组的6MWD、CO、SV高于对照组(P<0.05),两组不良反应发生率相近(P>0.05)。结论沙库巴曲缬沙坦治疗HFpEF安全有效,可改善患者无创血流动力学参数。

Objective To observe the clinical efficacy of sakubatril-valsartan and its influence on parameters of noninvasive dynamics in patients with heart failure with preserved ejection fraction(HFpEF).Methods The patients with HFpEF(n=148)were divided randomly into control group and observation group(each n=74).The control group was treated with ACEI/ARB and observation group was treated with sakubatril-valsartan.The clinical efficacy,6-minute walk distance(6MWD),chocardiogram[left ventricular end-diastolic inner diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF)],and noninvasive dynamics examinations[heart beat(HR),cardiac output(CO),cardiac index(CI),stroke volume(SV),stroke index(SI)]were compared between 2 groups.Results The total effective rate was 89.2%in observation group and 73.0%in control group(P<0.05).LVEF,6MWD,CO,CI,SV,SI increased and HR decreased in 2 groups after treatment(P<0.05).6MWD,CO and SV were higher in observation group than those in control group(P<0.05),and incidence rates of adverse reactions were similar in 2 groups(P>0.05).Conclusion Sakubatril-valsartan is safe and effective for treating HFpEF and can improve the parameters of noninvasive dynamics in HFpEF patients.