沙库巴曲缬沙坦治疗射血分数降低心力衰竭的临床疗效

Clinical effect of sacubitril/valsartan in treating heart failure with reduced ejection fraction

目的观察沙库巴曲缬沙坦治疗射血分数降低心力衰竭的临床疗效。方法选取2019年1月—2021年1月宁夏医科大学总医院心血管内科收治的射血分数降低心力衰竭患者100例,采用随机数字表法分为观察组和对照组,每组50例。对照组予常规抗心力衰竭治疗,观察组将沙库巴曲缬沙坦替代常规抗心力衰竭治疗中血管紧张素转换酶抑制剂/血管紧张素受体拮抗剂(ACEI/ARB),2组均治疗6个月。比较2组临床疗效,治疗前后N端脑利钠肽前体(NT-ProBNP)、血肌酐(SCr)水平、心功能指标[左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左心房前后径(LAD)、左室舒张末容积(LVEDV)、左室收缩末容积(LVESV)]及不良反应。结果治疗6个月后,观察组总有效率为78.00%,高于对照组的56.00%(χ^(2)=5.473,P=0.019);2组NT-ProBNP水平均较治疗前降低,且观察组低于对照组(P<0.01);2组治疗前后SCr水平比较差异均无统计学意义(P>0.05);2组LVEF均较治疗前升高,LVEDD、LAD、LVEDV及LVESV均较治疗前降低,且观察组升高/降低幅度大于对照组(P均<0.01)。观察组与对照组不良反应总发生率比较差异无统计学意义(6.00%vs.12.00%,χ^(2)=1.099,P=0.295)。结论沙库巴曲缬沙坦可显著提高射血分数降低心力衰竭患者临床治疗效果,明显改善心功能,且具有良好的安全性。

Objective To observe the clinical effect of sacubitril/valsartan in treating heart failure with reduced ejection fraction.Methods A total of 100 patients with heart failure with reduced ejection fraction admitted to the Department of Cardiovascular Medicine of Ningxia Medical University General Hospital from January 2019 to January 2021 were selected,and divided into observation group and control group by random number table method,with 50 cases in each group.The control group was treated with conventional anti-heart failure therapy,and the observation group replaced conventional angiotensin converting enzyme inhibitor/angiotensin receptor antagonist(ACEI/ARB)with sacubitril/valsartan in anti-heart failure treatment.Both groups were treated for 6 months.The clinical efficacy,N-terminal natriuretic peptide precursor(NT-ProBNP),serum creatinine(SCr)level,cardiac function indicators[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left atrial anteroposterior diameter(LAD),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV)]before and after treatment and adverse reactions were compared between the two groups.Results After 6 months of treatment,the observation group total effective rate was 78.00%,higher than that of control group(56.00%)(χ^(2)=5.473,P=0.019).The level of NT-ProBNP in the 2 groups were lower than that before treatment,and the observation group was lower than the control group(P<0.01).There were no significant difference in SCr level between 2 groups before and after treatment(P>0.05);LVEF in both groups were higher than before treatment,LVEDD,LAD,LVEDV and LVESV were lower than before treatment,and the increase/decrease amplitude of observation group were greater than control group(P<0.01).There was no significant difference in the total incidence of adverse reactions between the observation group and the control group(6.00%vs.12.00%,χ^(2)=1.099,P=0.295).Conclusion Sakubitril/valsartan can improve the clinical therapeutic effect in patients with heart failure with reduced ejection fraction,and significantly improve cardiac function,with good safety.