沙库巴曲缬沙坦治疗心力衰竭临床观察

Clinical Observation of Sacubitril Valsartan in the Treatment of Heart Failure

目的探讨沙库巴曲缬沙坦治疗心力衰竭的疗效,以及对患者心功能、血红素加氧酶1(HO-1)、炎性因子水平的影响。方法选取海南省定安县人民医院2019年6月至2021年8月收治的慢性心力衰竭患者80例,按随机数字表法分为观察组和对照组,各40例。两组患者均予强心利尿药等常规抗心力衰竭治疗,观察组患者在此基础上停用血管紧张素转化酶抑制剂类药物治疗36 h后给予沙库巴曲缬沙坦钠片治疗,均连续治疗3个月。结果观察组总有效率为95.00%,显著高于对照组的80.00%(P<0.05)。治疗后,观察组患者的心功能[左室射血分数(LVEF)和心排血量(CO)]均显著高于对照组(P<0.05);观察组患者内皮细胞损伤指标HO-1水平显著高于对照组,同型半胱氨酸(HCY)水平显著低于对照组(P<0.05);观察组患者炎性因子[白细胞介素6(IL-6)、白细胞介素18(IL-18)、超敏C反应蛋白(hs-CRP)]水平均显著低于对照组(P<0.05)。观察组患者治疗期间不良反应发生率为12.50%,显著低于对照组的32.50%(P<0.05)。结论沙库巴曲缬沙坦治疗心力衰竭疗效较好,可有效改善患者的心功能,升高HO-1水平,降低HCY,IL-6,IL-18,hs-CRP水平,且安全性良好。

Objective To investigate the efficacy of sacubitril valsartan in the treatment of heart failure,and its effect on the cardiac function,heme oxygenase-1(HO-1)and inflammatory factor levels of patients.MethodsA total of 80 patients with chronic heart failure admitted to the Dingan People′s Hospital of Hainan from June 2019 to August 2021 were selected and divided into the observation group and the control group by the random number table method,with 40 cases in each group.The patients in the two groups were given the conventional anti-heart failure treatment such as cardiotonics and diuretics,on this basis,the patients in the observation group were given Sacubitril Valsartan Sodium Tablets after stopping angiotensin converting enzyme inhibitor(ACEI)for 36 h.All patients were treated for three consecutive months.ResultsThe total effective rate in the observation group was 95.00%,which was significantly higher than 80.00%in the control group(P<0.05).After treatment,the levels of cardiac function indexes[left ventricular ejection fraction(LVEF)and cardiac output(CO)]in the observation group were significantly higher than those in the control group(P<0.05).After treatment,the levels of endothelial cell injury indexes HO-1 and homocysteine(HCY)in the observation group were significantly higher and lower than those in the control group(P<0.05)respectively.After treatment,the levels of inflammatory factors[interleukin-6(IL-6),interleukin-18(IL-18)and hypersensitive C-reactive protein(hs-CRP)]in the observation group were significantly lower than those in the control group(P<0.05).The incidence of adverse reactions during treatment in the observation group was 12.50%,which was significantly lower than 32.50%in the control group(P<0.05).ConclusionSacubitril valsartan is effective and safe in the treatment of heart failure,which can effectively improve the cardiac function of patients,increase the level of HO-1,and reduce the levels of HCY,IL-6,IL-18 and hs-CRP.