沙库巴曲缬沙坦治疗老年射血分数降低心力衰竭患者效果观察

Observation on the effect of sarcubatrixartan in the treatment of geriatric patients with heart failure with reduced ejection fraction

目的观察沙库巴曲缬沙坦治疗老年射血分数降低心力衰竭患者的临床效果及安全性。方法招募老年心力衰竭患者120例,随机数表法分为对照组和沙库巴曲缬沙坦组(S/V组),每组各60例。两组均给予限钠、利尿等常规基础治疗。对照组继续口服肾素-血管紧张素系统抑制剂。S/V组洗脱后开始口服沙库巴曲缬沙坦钠片,滴定至患者的最大耐受量。持续治疗12个月。比较两组入组时及治疗12个月后的B型钠尿肽前体(NT-proBNP)、左室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、6分钟步行试验(6 MWT)距离及美国堪萨斯城心肌病患者生存质量表(KCCQ)评分。比较随访期间因心衰发作住院、因心血管死亡情况及不良反应发生率。结果两组入组时,NT-proBNP、LVEF、LVEDD、6 MWT、KCCQ差异均无统计学意义(P>0.05)。12个月后,两组LVEF、6MWT距离较入组时升高且S/V组高于对照组,差异有统计学意义(P<0.05)。12个月后S/V组LVEDD低于入组时和对照组治疗后,S/V组KCCQ评分高于入组时,差异均有统计学意义(P<0.05)。随访期间对照组心衰住院率为18.64%(11/59),S/V组住院率为13.33%(8/60),两组间差异无统计学意义(χ~2=0.625,P=0.425)。两组不良反应发生率差异无统计学意义(χ~2=0.501,P=0.479)。结论对于老年射血分数降低心力衰竭患者,沙库巴曲缬沙坦能改善患者心功能提高生活质量,且安全性良好。

Objective To observe the clinical effect and safety of sarcubatrix valsartan in the treatment of geriatric patients with low ejection fraction and heart failure.Methods A total of 120 elderly patients with heart failure were recruited and randomly divided into two groups:control group and sakubatravalsartan group(S/V group),with 60 patients in each group.Both groups received routine basic treatment,such as sodium restriction and diuresis.The control group continued to take renin-angiotensin system inhibitor orally.After elution,patients in the S/V group began to sabatatrivalsartan sodium tablets orally,and were titrated to the maximum tolerated dose.The treatment lasted for 12 months.The scores of NT-proBNP,LVEF,LVEDD,6-minute walking test(6MWT),and the quality of life with cardiomyopathy in Kansas city(KCCQ)were compared between the two groups at the time of enrollment and after 12 months of treatment.During the follow-up period,hospitalization due to heart failure attack,cardiovascular death,and the incidence of adverse reactions were compared.Results There was no significant difference in NT-proBNP,LVEF,LVEDD,6MWT and KCCQ between the two groups when they were enrolled(P>0.05).After 12 months,the distance between LVEF and 6MWT in the two groups was higher than that in the group,and the S/V group was higher than that in the control group,the difference was statistically significant(P<0.05).After 12 months,the LVEDD of S/V group was lower than that at the time of admission and the KCCQ score of S/V group was higher than that at the time of admission,the difference was statistically significant(P<0.05).During the follow-up period,the hospitalization rate of heart failure in the control group was 18.64%(11/59),and that in the S/V group was 13.33%(8/60).There was no statistically significant difference between the two groups(χ2=0.625,P=0.425).There was no statistically significant difference in the incidence of adverse reactions between the two groups(χ2=0.501,P=0.479).Conclusion For geriatric patients with lower ejection fraction and heart failure,sabatatrivalsartan can improve cardiac function,enhance quality of life,and demonstrate good safety.