冻干重组人脑利钠肽序贯沙库巴曲缬沙坦钠片治疗心力衰竭的临床效果

Clinical effect of lyophilized recombinant human brain natriuretic peptide followed by sacubitril valsartan sodium tablets in the treatment of heart failure

目的观察冻干重组人脑利钠肽(新活素)序贯沙库巴曲缬沙坦钠片(诺欣妥)治疗心力衰竭的临床效果。方法回顾性选取2016年1月—2020年12月于福建省三明市中西医结合医院接受治疗的心力衰竭患者250例,根据治疗方案不同分为观察组131例和对照组119例。2组患者入院后均行常规对症治疗,对照组在常规对症治疗的基础上给予β-受体阻滞剂(酒石酸美托洛尔或琥珀酸美托洛尔)、血管紧张素转换酶抑制剂(培哚普利片)治疗,观察组在常规对症治疗的基础上给予新活素序贯诺欣妥治疗,2组均连续治疗1个月。比较2组患者治疗前后的心功能指标、N末端脑钠肽前体(NT-proBNP)、胱抑素C(Cys C)、C反应蛋白(CRP)水平,比较2组患者的心功能等级及治疗结束后1个月内的再住院情况。结果治疗1个月后,2组患者的左室射血分数(LVEF)、左室短轴缩短分数(FS)均高于治疗前,左室舒张末期内径(LVEDD)均低于治疗前,且观察组患者升高/降低幅度大于对照组,差异均有统计学意义(P<0.01);2组患者的NT-proBNP、Cys C及CRP水平均低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.01);观察组心功能等级为Ⅰ级的比例为51.15%,明显高于对照组的31.93%,差异有统计学意义(P<0.01)。治疗结束后1个月内,观察组患者的再住院率为11.45%(15/131),低于对照组的22.69%(27/119),差异有统计学意义(χ^(2)=5.635,P=0.018)。结论新活素序贯诺欣妥治疗心力衰竭可有效提高治疗效果,改善心功能与临床症状,降低患者的再住院率,预后良好。

Objective To observe the clinical effect of lyophilized recombinant human brain natriuretic peptide(Xinhuosu)followed by sacubitril valsartan sodium tablets(Nuoxintuo)in the treatment of heart failure.Methods 250 patients with heart failure who received treatment in Sanming Integrated Medicine Hospital,Fujian Province from January 2016 to December 2020 were retrospectively selected,and they were divided into observation group(131 cases)and control group(119 cases)according to different treatment plans.Both groups received routine symptomatic treatment after admission,while the control group receivedβ-blocker(metoprolol tartrate or metoprolol succinate),angiotensin converting enzyme inhibitor(perindopril tablets)on the basis of routine symptomatic treatment treatment,the observation group was added with Xinhuosu followed by Nuoxintuo on the basis of routine symptomatic treatment,both groups were treated continuously for 1 month.The cardiac function indexes,N-terminal pro-brain natriuretic peptide(NT-proBNP),cystatin C(Cys C)and C-reactive protein(CRP)levels were compared between the two groups before and after treatment,the cardiac function grade and readmission within 1 month after treatment were compared between the two groups.Results After 1 month of treatment,the left ventricular ejection fraction(LVEF)and fraction shortening(FS)in both groups were higher than those before treatment,and the left ventricular end diastolic diameter(LVEDD)was lower than before treatment,the increase/decrease range of the observation group were greater than those of the control group,and the difference were statistically significant(P<0.01);The levels of NT-proBNP,Cys C and CRP in the two groups were lower than those before treatment,and the observation group were lower than the control group,the differences were statistically significant(P<0.01);The proportion of cardiac function grade in the observation group withⅠlevel was 51.15%,which was significantly higher than 31.93%in the control group,and the difference was statistically significant(P<0.01).Within 1 month after the end of treatment,the readmission rate of patients in the observation group was 11.45%(15/131),which was lower than 22.69%(27/119)in the control group,and the difference was statistically significant(χ^(2)=5.635,P=0.018).Conclusion The treatment of heart failure with Xinhuosu followed by Nuoxintuo can effectively improve the therapeutic effect,improve cardiac function and clinical symptoms,reduce the rehospitalization rate of patients,and has a good prognosis.