沙库巴曲缬沙坦钠对慢性心力衰竭患者sST2、hFABP、Lp-PLA2水平及神经内分泌激素的影响

Effects of Sacubitril/Valsartan Sodium on sST2,hFABP, Lp-PLA2 Levels and Neuroendocrine Hormones in Patients with Chronic Heart Failure

目的 探究沙库巴曲缬沙坦钠治疗CHF对患者sST2、hFABP、Lp-PLA2水平及神经内分泌激素的影响。方法 将某院心血管内科2019年12月1日-2020年12月31日收治的67例CHF患者,通过随机数字表法分为试验组(33例)和对照组(34例)。对照组接受常规西药治疗+盐酸贝那普利片治疗,而试验组接受常规西药治疗+沙库巴曲缬沙坦钠治疗,两组均治疗3个月。比较两组治疗前后神经内分泌激素、心功能、炎性因子及疾病相关因子(sST2、hFABP、Lp-PLA2)水平。结果 治疗后,两组血清PRA、AngⅡ、ALD水平均较治疗前降低,且试验组更低(1.52±0.43)pg/mL vs (2.27±0.39)pg/mL,(67.12±6.38)pg/mL vs(92.89±6.94)pg/mL,(241.76±15.21)ng/mLvs(282.69±16.37)ng/mL(P<0.05)。治疗后,两组LVEDD、LVESD水平均较治疗前降低,且试验组更低(36.28±3.65)mmvs(45.17±3.76)mm,(51.29±4.82)mmvs(59.14±3.47)mm(P<0.05);两组左室射血分数(LVEE)水平升高,且试验组更高(P<0.05)(47.92±6.56)%vs (41.95±8.31)%(P<0.05)。治疗后,两组血清TNF-α、IL-6及CRP水平均较治疗前降低,且试验组更低(112.98±14.46)ng/L vs (135.67±15.71)ng/L,(44.26±7.13)ng/L vs (57.63±8.87)ng/L,(11.52±2.18)ng/L vs (16.56±3.61)ng/L(P<0.05)。治疗后,两组血清sST2、hFABP、Lp-PLA2水平均较治疗前降低,且试验组更低(42.28±4.65)pg/mLvs(54.17±4.76)pg/mL,(8.29±4.82)μg/Lvs(11.84±3.47)μg/L,(224.68±34.27)mg/Lvs(287.63±38.13)mg/L(P<0.05)。结论 沙库巴曲缬沙坦钠治疗CHF可提高患者心功能,降低心肌炎性损伤,可能与其调节神经内分泌激素分泌,降低sST2、hFABP、Lp-PLA2表达有关。

Objectives This study aims to investigate the effect of Sacubitril/Valsartan sodium in the treatment of CHF on the levels of sST2,h FABP, Lp-PLA2, and neuroendocrine hormones in patients.Methods A total of 67 CHF patients admitted to the Department of Cardiovascular Medicine in a hospital from December 1, 2019 to December 31, 2020 were divided into an experimental group(33 cases) and a control group(34 cases) by random number table method. The control group received conventional western medicine treatment and benazepril hydrochloride tablet treatment, while the experimental group received conventional western medicine treatment and Sacubitril/Valsartan sodium treatment. Both groups were treated for 3 months. The levels of neuroendocrine hormones, cardiac function, inflammatory factors, and disease-related factors(s ST2,h FABP, Lp-PLA2) before and after treatment were compared between the two groups.Results After treatment, the levels of serum PRA, AngⅡ, and ALD in both groups were reduced, and the observation group was lower than the control group(1.52±0.43)pg/m L vs(2.27±0.39)pg/m L,(67.12±6.38)pg/m L vs(92.89±6.94)pg/m L,(241.76±15.21)ng/m L vs(282.69±16.37)ng/m L(P<0.05). After treatment, LVESD and LVEDD levels in both groups decreased, and the observation group was lower(36.28±3.65) mm vs(45.17±3.76)mm,(51.29±4.82) mmvs(59.14±3.47) mm(P<0.05). LVEE level increased in the two groups and was higher in the observation group(47.92±6.56) % vs(41.95±8.31) %(P<0.05). After treatment, serum levels of TNF-α,CRP, IL-6 in both groups were significantly lower than those before treatment, and the observation group was lower than the control group(112.98±14.46) ng/L vs(135.67±15.71) ng/L,(44.26±7.13) ng/L vs(57.63±8.87)ng/L,(11.52±2.18) ng/L vs(16.56±3.61) ng/L(P<0.05). After treatment, serum levels of sST2,h FABP, and Lp-PLA2 in both groups were significantly lower than before treatment, and the observation group was lower than the control group(42.28±4.65)pg/m L vs(54.17±4.76)pg/m L,(8.29±4.82)μg/L vs(11.84±3.47)μg/L,(224.68±34.27) mg/L vs(287.63±38.13) mg/L(P<0.05).Conclusions Sacubitril/Valsartan sodium in the treatment of CHF can improve cardiac function and reduce myocardial inflammatory injury, which may be related to the regulation of neuroendocrine hormone secretion and the reduction of sST2,h FABP, and Lp-PLA2 expression.