沙库巴曲缬沙坦联合左卡尼汀注射液治疗急性失代偿性心力衰竭患者的效果

Effects of Sacubitril/Valsartan combined with Levocarnitine injection in treatment of patients with acute decompensated heart failure

目的:观察沙库巴曲缬沙坦联合左卡尼汀注射液治疗急性失代偿性心力衰竭(ADHF)患者的效果。方法:选取2019年2月至2021年4月该院收治的123例ADHF患者进行前瞻性研究,按照随机数字表法分为对照组(n=61)和观察组(n=62)。对照组予以左卡尼汀注射液治疗,观察组在对照组基础上联合沙库巴曲缬沙坦治疗。比较两组临床疗效,治疗前后心功能指标[左心室收缩末期内径(LVESD)、左心室收缩末期容积(LVESV)、左室射血分数(LVEF)]水平、肾功能指标[胱抑素C(Cys-C)、肾小球滤过率(GFR)、血肌酐(Scr)]水平、心肌损伤相关因子指标[生长刺激表达基因2蛋白(sST2)、半乳糖凝集素3(Gal-3)、可溶性白细胞分化抗原40配体(sCD40L)]水平、病情相关指标[组织蛋白酶S(CatS)、血小板反应蛋白-1(TSP-1)、卵泡抑素样蛋白1(FSTL1)]水平,以及随访1年不良事件发生率。结果:观察组治疗总有效率为90.32%,高于对照组的77.05%,不良事件发生率为8.62%,低于对照组的22.41%,差异均有统计学意义(P<0.05);治疗后,观察组LVESD、LVESV、Cys-C、Scr、sST2、Gal-3、sCD40L、CatS、TSP-1、FSTL1水平均低于对照组,LVEF、GFR水平均高于对照组,差异有统计学意义(P<0.05)。结论:沙库巴曲缬沙坦联合左卡尼汀注射液治疗ADHF患者可提高治疗总有效率,改善心功能指标和肾功能指标水平,降低心肌损伤相关因子指标、病情相关指标水平和不良事件发生率,优于单纯左卡尼汀注射液治疗效果。

Objective:To observe effects of Sacubitril/Valsartan combined with Levocarnitine injection in the treatment of patients with acute decompensated heart failure(ADHF).Methods:A prospective study was conducted on 123 patients with ADHF admitted to the hospital from February 2019 to April 2021.They were divided into control group(n=61)and observation group(n=62)according to the random number table method.The control group was treated with Levocarnitine injection,while the observation group was treated with Sacubitril/Valsartan on the basis of that of the control group.The clinical efficacy,the levels of cardiac function indexes[left ventricular end-systolic diameter(LVESD),left ventricular end-systolic volume(LVESV),left ventricular ejection fraction(LVEF)],the levels of renal function indexes[cystatin C(Cys-C),glomerular filtration rate(GFR),serum creatinine(Scr)],the levels of myocardial injury related factors[growth stimulation expressed gene 2 protein(sST2),galactose lectin 3(Gal-3),soluble leukocyte differentiation antigen 40 ligand(sCD40L)],the levels of disease related indexes[cathepsin S(CatS),thrombospondin-1(TSP-1),follistatin-like protein 1(FSTL1)],and the incidence of adverse events of 1 year-follow up were compared between the two groups.Results:The total effective rate of the observation group was 90.32%,which was higher than the control group of 77.05%;the incidence of adverse events was 8.62%,which was lower than the control group of 22.41%;and the differences were statistically significant(P<0.05).After treatment,the levels of LVESD,LVESV,Cys-C,Scr,sST2,Gal-3,sCD40L,CatS,TSP-1,FSTL1 in the observation group were lower than those in the control group,while the levels of LVEF and GFR were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusions:Sacubitril/Valsartan combined with Levocarnitine injection in the treatment of the ADHF patients can improve the total effective rate of treatment,improve the levels of cardiac function indexes and renal function indexes,and reduce the levels of myocardial injury related factors,the levels of disease related indexes and the incidence of adverse events.Moreover,it is superior to single Levocarnitine injection treatment.