沙库巴曲缬沙坦对高龄射血分数降低的心力衰竭患者心功能及血清NT-proBNP、Gal-3浓度的影响

Effects of sacubitril and valsartan on cardiac function and serum NT-proBNP and Gal-3 concentrations in elderly patients with heart failure with reduced ejection fraction

目的 探究沙库巴曲缬沙坦对高龄射血分数降低的心力衰竭(HFrEF)患者心功能及血清N末端脑钠肽前体(NT-proBNP)、半乳糖凝集素-3(Gal-3)浓度的影响。方法 连续入选2019年2月至2020年12月我院住院治疗的高龄HFrEF患者95例,依据治疗药物的不同分为对照组和沙库巴曲缬沙坦组。对照组47例给予贝那普利治疗,沙库巴曲缬沙坦组48例给予沙库巴曲缬沙坦治疗,6个月后,对比两组患者心功能指标、血清细胞因子水平,生活质量及不良反应。结果 两组治疗6月后左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)水平经比较差异有统计学意义(P<0.05)。两组治疗6月后NT-proBNP、GDF-15、Gal-3水平经比较差异有统计学意义(P<0.05)。两组治疗3月末KCCQ、MLHF评分经比较差异有统计学意义(P<0.05)。沙库巴曲缬沙坦组不良反应率4.17%(2/48)与对照组6.38%(3/47),经比较差异无统计学意义。结论 沙库巴曲缬沙坦治疗高龄HFrEF患者,通过拮抗肾素-血管紧张素-醛固酮系统,以调节心功能指标,调控血清细胞因子水平,改善生活质量。

Objective To investigate the effects of sacubitril and valsartan on cardiac function and serum NT-proBNP and Gal-3 concentrations in elderly patients with heart failure with reduced ejection fraction(HFrEF).Methods Ninety-five elderly patients with HFrEF who were hospitalized in our hospital from February 2019 to December 2020 were consecutively enrolled and divided into the control group and the sacubitril valsartan group according to different treatment drugs. Forty-seven patients in the control group were treated with benazepril, and 48 patients in the sacubitril valsartan group were treated with sacubitril and valsartan. After 6 months, cardiac function indexes, serum cytokine levels, quality of life and adverse reactions were compared between the two groups.Results There were significant differences in the levels of LVEF, LVEDD and LVESD between the two groups after six months of the treatment(P<0.05). There were significant differences in the levels of NT-proBNP, GDF-15 and Gal-3 between the two groups after six months of the treatment(P<0.05). There were significant differences in KCCQ and MLHF scores between the two groups after three months of the treatment(P<0.05). The adverse reaction rate was 4.17%(2/48) in the sacubitril valsartan group and it was 6.38%(3/47) in the control group, and there was no significant difference between the two groups.Conclusion The treatment of elderly patients with HFrEF by sacubitril and valsartan antagonizes renin-angiotensin-aldosterone system, regulates cardiac function index, regulates serum cytokine level, and improves quality of life.