沙库巴曲缬沙坦钠治疗慢性射血分数降低的心力衰竭的临床疗效

Clinical efficacy of sacubitril valsartan sodium in the treatment of chronic heart failure with reduced ejection fraction

目的观察沙库巴曲缬沙坦钠治疗慢性射血分数降低的心力衰竭的临床疗效。方法选取2019年5月—2021年2月北京中医药大学房山医院收治的慢性射血分数降低的心力衰竭患者66例,按照随机数字表法分为常规组与研究组,各33例。2组患者均予以对症处理,常规组予以盐酸贝那普利,研究组予以沙库巴曲缬沙坦钠,2组均治疗12个月。比较2组临床疗效,治疗前后左心室射血分数(LVEF)、6 min步行试验(6MWT)、心肌损伤标志物[心肌肌钙蛋白I(cTnI)、N末端脑钠肽前体(NT-proBNP)]、血清炎性因子[白介素(IL)-6、IL-1]及不良反应。结果研究组治疗总有效率为93.94%,高于常规组的75.76%(χ^(2)=4.243,P=0.039)。治疗后,2组LVEF高于治疗前,6MWT长于治疗前,cTnI、NT-proBNP低于治疗前,且研究组LVEF高于常规组,6MWT长于常规组,cTnI、NT-proBNP低于常规组(P<0.01)。治疗后,2组血清IL-6、IL-1水平低于治疗前,且研究组低于常规组(P<0.01)。2组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论沙库巴曲缬沙坦钠治疗慢性射血分数降低的心力衰竭的临床疗效确切,可有效改善患者的心功能,减轻心肌损伤及炎性反应,且安全性较高。

Objective To observe the clinical efficacy of sacubitril valsartan sodium in the treatment of chronic heart failure with reduced ejection fraction.Methods A total of 66 cases of patients with chronic heart failure with reduced ejection fraction were selected from May 2019 to February 2021 in Fangshan Hospital of Beijing University of Traditional Chinese Medicine,which were divided into routine group and research group according to the random number table method,with 33 cases in each group.Patients in the two groups were given symptomatic treatment.The routine group was given benazepril hydrochloride,and the research group was given sacubitril valsartan sodium.Both groups were treated for 12 months.Clinical efficacy,LVEF,6 min walking test(6MWT),myocardial injury markers(cTnI,NT-proBNP),serum inflammatory factors(IL-6,IL-1)before and after treatment,incidence of adverse reactions were compared between the two groups.Results The total effective rate of the research group was 93.94%,which was higher than 75.76%of the routine group(χ^(2)=4.243,P=0.039).After treatment,the LVEF of the two groups was higher than that before treatment,6MWT was longer than that before treatment,and cTnI and NT-proBNP were lower than those before treatment,and LVEF of the research group was higher than that of the routine group,6MWT was longer than that of the routine group,and cTnI and NT-proBNP were lower than those of the routine group(P<0.01).After treatment,the serum levels of IL-6 and IL-1 in the two groups were lower than those before treatment,and those in the research group were lower than those in the routine group(P<0.01).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Sacubitril valsartan sodium have an exact clinical effect for chronic heart failure with reduced ejection fraction,which can effectively improve cardiac function of patients,reduce myocardial injury and inflammatory reaction,and reduce the level of inflammatory factors,and with high safety.