沙库巴曲缬沙坦治疗老年心力衰竭的研究进展

Research Progress of Sacubitril Valsartan in the Treatment of Senile Heart Failure

心力衰竭在临床上并不属于独立的疾病,而是众多心脏疾病发展到终末阶段的一种临床综合征。临床上治疗心力衰竭患者的常用药物主要以β受体阻滞剂、醛固酮受体拮抗剂、血管紧张素转化酶抑制剂或血管紧张素Ⅱ受体阻滞剂为主,虽然上述药物对于心力衰竭患者而言具有较为理想的疗效,但对于老年心力衰竭患者而言,因其各项身体机能正处于逐渐衰退的趋势,导致老年心力衰竭患者在服用上述药物治疗的过程中容易发生水电解质紊乱的情况,主要的临床症状有四肢无力、胃肠功能障碍等,部分患者还会出现软瘫等不良情况,从而降低了患者的用药依从性。而沙库巴曲缬沙坦作为一种双重抑制的超分子钠盐复合物,主要是由脑啡肽酶抑制剂和血管紧张素Ⅱ受体拮抗剂根据摩尔比的比例组成的,通过美国和欧盟的批准上市后,已经被广泛应用于心力衰竭的临床治疗中。相关的医学数据表明,沙库巴曲缬沙坦能有效提高老年心力衰竭患者的用药依从性,降低患者的心血管疾病死亡率,改善预后。因此,文章就沙库巴曲缬沙坦的药代动力学、作用机制和在老年心力衰竭中的临床疗效作以下综述。

Heart failure is not an independent disease in clinic,but a clinical syndrome in the terminal stage of many heart diseases.The commonly used drugs in clinical treatment for heart failure patients are beta blockers,aldosterone receptor antagonist,angiotensin converting enzyme inhibitors or angiotensinⅡreceptor blockers.Although these drugs achieve ideal curative effects in patients with heart failure,they can lead to water and electrolyte disorders in elderly patients whose physical function are gradually declining.The main clinical symptoms include limb weakness,gastrointestinal dysfunction,etc.,and some patients may appear soft paralysis and other adverse conditions,which reduces the medication compliance of patients.As a double-inhibitory supramolecular sodium complex,sacubitril valsartan is mainly composed of enkephalin inhibitors and angiotensinⅡreceptor antagonist in accordance with the molar ratio.The drug has been widely used in the clinical treatment of heart failure after being approved by the United States and the European Union.Relevant medical data show that sacubitril valsartan can effectively improve medication compliance of elderly patients with heart failure,reduce cardiovascular mortality and improve prognosis.Therefore,this paper reviews the pharmacokinetics,mechanisms and clinical efficacy of sacubitril valsartan in the treatment of senile heart failure.