左西孟旦联合沙库巴曲缬沙坦钠对射血分数保留型心力衰竭患者心功能、心室重塑及预后的影响

Effects of Levosimendanin Combination with Sacubitril and Valsartan Sodium on Cardiac Function,Ventricular Remodeling and Prognosis of Patients with Heart Failure with Preserved Ejection Fraction

目的:探讨左西孟旦联合沙库巴曲缬沙坦钠对射血分数保留型心力衰竭(HFpEF)患者心功能、心室重塑及预后的影响。方法:回顾性选取2018年7月~2020年6月本院收治的120例HFpEF患者为研究对象,根据治疗方案分为对照组(n=63)和观察组(n=57)。对照组在常规治疗基础上给予沙库巴曲缬沙坦钠片,观察组在对照组基础上加用左西孟旦注射液,两组均连续治疗4周。比较两组治疗前后的Tei指数、左室射血分数(LVEF)、N末端B型利钠肽前体(NT-proBNP)等心功能指标以及左室舒张末期后壁厚度(LVPWT)、舒张末期室间隔厚度(IVST)、左室质量指数(LVMI)等心室重塑指标。比较两组不良反应发生率。治疗后两组均随访1年,比较两组随访期间因心源性相关事件导致的再住院率和死亡率。结果:两组治疗后的Tei指数、血浆NT-proBNP水平、LVPWT、IVST、LVMI均低于治疗前,而LVEF高于治疗前(P<0.05);观察组治疗后的Tei指数、血浆NT-proBNP水平、LVPWT、IVST、LVMI均低于对照组,而LVEF高于对照组(P<0.05)。两组头晕、过敏、胃肠道反应等不良反应发生率比较无统计学差异(P>0.05)。观察组随访期间心源性相关事件所致再住院率、死亡率均低于对照组(P<0.05)。结论:左西孟旦联合沙库巴曲缬沙坦钠可有效改善HFpEF患者的心功能、心室重塑及预后,且安全性较高。

Objective:To investigate the effects of levosimendanin combination with sacubitril and valsartan sodium on cardiac function,ventricular remodeling and prognosis of patients with heart failure with preserved ejection fraction(HFpEF).Methods:The clinical data of 120 patients with HFpEF admitted from July 2018 to June 2020 were retrospectively analyzed.The patients were assigned into control group(conventional treatment plus sacubitril and valsartan sodium,n=63)and observation group(treatment used in the control group plus levosimendan,n=57)according to their treatment regimen and all treat for 4 weeks continuously.The pre-and post-treatment cardiac function indexes,such as Tei index,left ventricular ejection fraction(LVEF),and N-terminal pro-B-type brain natriuretic peptide(NT-proBNP)and pre-and post-treatment ventricular remodeling indexes,such as left ventricular end-diastolic posterior wall thickness(LVPWT),interventricular septum thickness(IVST),left ventricular mass index(LVMI)the two groups were compared.The rate of adverse reactions between the two groups was statistically compared.Both groups finished the complete follow-up period after treatment,and the prognosis indexes such as cardiogenic rehospitalization rate and mortality rate of patients in the two groups during the 1-year follow-up were statistically compared.Results:The post-treatment Tei index,plasma NT-proBNP level,LVPWT,IVST and LVMI in the two groups were all lower than those of pre-treatment(P<0.05);while the post-treatment LVEF in the two groups was higher than that of pre-treatment(P<0.05);And the post-treatment Tei index,plasma NT-proBNP level,LVPWT,IVST,LVMI in the observationgroupwere lower than those in the control group,while posttreatment LVEF in the observation group was higher than that in the control group(P<0.05).There was no significant difference in the rate of adverse reactions such as dizziness,allergies,and gastrointestinal reactions between the two groups(P>0.05).The cardiogenic rehospitalization rate and mortality rate of patients in the observation group were lower than those in the control group(P<0.05).Conclusion:Levosimendanin combination with sacubitril and valsartan sodium is helpful in improving the cardiac function,ventricular remodeling and prognosis of patients with HFpEF.