沙库巴曲缬沙坦钠治疗瓣膜病心力衰竭的效果及对血清miRNA-21的影响

Efficacy of Salkubazol Valsartan Sodium in the treatment of heart failure in patients with valvular disease and its effect on serum miRNA-21

目的探讨沙库巴曲缬沙坦钠片治疗瓣膜病慢性心力衰竭的效果及对血清miRNA-21水平的影响。方法选取2018年3月至2021年5月粤北人民医院心血管内科门诊收治的84例瓣膜病心力衰竭患者作为研究对象,采用随机数字表法进行分组并实施双盲,将患者分为治疗组和对照组,每组各42例。两组患者均服用呋塞米、螺内酯、比索洛尔治疗,治疗组患者采用沙库巴曲缬沙坦钠,对照组患者采用替米沙坦,两组患者均治疗5个月。比较两组患者治疗前后的6 min步行距离和血清miRNA-21水平。结果治疗组患者治疗第2、3、4、5个月的6 min步行距离长于对照组,差异有统计学意义(P<0.001);两组患者治疗第5个月的6 min步行距离长于治疗前,差异有统计学意义(P<0.001)。治疗组患者治疗第3、4、5个月的血清miRNA-21水平低于对照组,差异有统计学意义(P<0.001);两组患者治疗第5个月的血清miRNA-21水平低于治疗前,差异有统计学意义(P<0.001)。结论沙库巴曲缬沙坦钠可显著提高瓣膜病心力衰竭患者的6 min步行距离,可能与下调miRNA-21的表达有关。

Objective To investigate the therapeutic effect of Sacubitril Valsartan Sodium Tablet on chronic heart failure in patients with valvular disease and its effect on the level of serum miRNA-21.Methods A total of 84 patients with valvular disease and heart failure admitted to the Outpatient Department of Cardiovascular Medicine of Yuebei People′s Hospital from March 2018 to May 2021 were selected as the study subjects.The random number table method was used for grouping and double-blind,and patients were divided into treatment group and control group,with 42 patients in each group.Patients in both groups were treated with Furosemide,Spironolactone and Bisoprolol.Patients in the treatment group were treated with Sacubitril Valsartan Sodium and patients in the control group were treated with Telmisartan.Both groups were treated for 5 months.The 6-min walking distance and serum miRNA-21 level were compared between the two groups before and after treatment.Results The 6 min walking distance of the treatment group was longer than that of the control group at 2,3,4 and 5 months of treatment,and the difference was statistically significant(P<0.001).The 6-min walking distance of the two groups in the 5 month of treatment were longer than those before treatment,and the differences were statistically significant(P<0.001).The serum miRNA-21 level in treatment group was lower than that in control group at 3,4 and 5 months of treatment,the difference was statistically significant(P<0.001).The serum miRNA-21 levels in the two groups at 5 months of treatment were lower than those before treatment,the differences were statistically significant(P<0.001).Conclusion Sacubitril Valsartan Sodium has a significant effect on the prolongation of 6 min walking distance in patients with cardiac valvular heart failure,and this effect may be related to the down regulation of miRNA-21 expression.