沙库巴曲缬沙坦钠治疗急性左心室射血分数降低心力衰竭患者的临床疗效及安全性观察

Clinical Efficacy and Safety of Sacubatril/Valsartan in the Treatment of Acute Heart Failure with Reduced Left Ventricular Ejection Fraction

目的观察沙库巴曲缬沙坦钠治疗急性左心室射血分数降低心力衰竭患者的临床疗效及安全性。方法选取2021年1月-2022年1月在我院诊治的88例急性左心室射血分数降低心力衰竭患者为研究对象,采用随机数字表法分为对照组和观察组,各44例。对照组采用常规治疗,观察组给予沙库巴曲缬沙坦钠治疗,比较两组临床疗效、心功能指标、6 min步行试验(6MWT)距离、再住院率、不良反应发生率、心率以及血压水平。结果观察组治疗总有效率为93.18%,高于对照组的81.82%(P<0.05);两组治疗后左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)均低于治疗前,左射血分数(LVEF)均高于治疗前,且观察组LVEDD、LVESD低于对照组,LVEF高于对照组(P<0.05);两组治疗后6MWT均大于治疗前,且观察组大于对照组(P<0.05);随访6个月,观察组再住院率为11.36%,低于对照组的27.27%(P<0.05);观察组不良反应发生率为9.09%,与对照组的11.36%比较,差异无统计学意义(P>0.05);两组治疗后收缩压、心率均低于治疗前,且观察组收缩压低于对照组(P<0.05);观察组心率与对照组比较,差异无统计学意义(P>0.05)。结论沙库巴曲缬沙坦钠治疗急性左心室射血分数降低心力衰竭患者效果确切,可提高治疗总有效率,改善心功能指标,增大6 min步行试验,降低再住院率,且不会增加不良反应发生率,可实现较理想的疗效,值得临床应用。

Objective To observe the clinical efficacy and safety of Sacubatril/Valsartan in the treatment of heart failure with reduced acute left ventricular ejection fraction.Methods A total of 88 patients with acute heart failure with reduced left ventricular ejection fraction who were treated in our hospital from January 2021 to January 2022 were selected as the research objects.They were divided into control group and observation group by random number table method,with 44 patients in each group.The control group was treated with routine treatment,and the observation group was treated with Sacubatril/Valsartan.The clinical efficacy,cardiac function index,6 min walking test(6MWT)distance,rehospitalization rate,incidence of adverse reactions,heart rate and blood pressure level were compared between the two groups.Results The total effective rate of treatment in the observation group was 93.18%,which was higher than 81.82%in the control group(P<0.05).After treatment,left ventricular end-diastolic diameter(LVEDD)and left ventricular end-systolic diameter(LVESD)in the two groups were lower than those before treatment,and left ventricular ejection fraction(LVEF)was higher than that before treatment,and LVEDD and LVESD in the observation group were lower than those in the control group,LVEF was higher than that in the control group(P<0.05).The 6MWT of the two groups after treatment was greater than that before treatment,and that in the observation group was greater than that in the control group(P<0.05).After 6 months of follow-up,the rehospitalization rate of the observation group was 11.36%,which was lower than 27.27%of the control group(P<0.05).The incidence of adverse reactions in the observation group was 9.09%,which was compared with 11.36%in the control group,the difference was not statistically significant(P>0.05).The systolic blood pressure and heart rate of the two groups after treatment were lower than those before treatment,and the systolic blood pressure of the observation group was lower than that of the control group(P<0.05).There was no significant difference in heart rate between the observation group and the control group(P>0.05).Conclusion Sacubatril/Valsartan is effective in the treatment of patients with acute heart failure with reduced left ventricular ejection fraction,which can improve the total effective rate of treatment,improve the cardiac function index,increase the 6 min walking test,reduce the rehospitalization rate,and will not increase the incidence of adverse reactions.Meanwhile,it can achieve a better therapeutic effect and is worthy of clinical application.