沙库巴曲缬沙坦治疗合并冠心病的射血分数中间值心力衰竭患者的临床观察

Clinicalobservation of Sacubitril Valsartan in the treatment of heart failure with middlerange ejection fraction with coronary heart disease

目的观察沙库巴曲/缬沙坦对合并冠心病的射血分数中间值心力衰竭(HFmrEF)患者的心脏结构、活动耐量的影响。方法选取2021年3月至2022年3月本院合并冠心病的87例HFmrEF患者为研究对象。其中43例给予沙库巴曲/缬沙坦作为治疗组,44例给予肾素血管紧张素系统抑制剂常规治疗作为对照组。观察两组治疗1年后心脏结构的变化及患者活动耐量的改善。结果与治疗前比较,两组治疗后6 min步行距离更远,左心房、左心室内径缩小,氨基末端脑钠肽前体(NT-proBNP)水平更低,堪萨斯心肌病问卷(KCCQ)评分更高(P<0.05)。与对照组比较,治疗组治疗后6 min步行距离更远,左心室内径更小(P<0.05)。结论沙库巴曲/缬沙坦用于合并冠心病的HFmrEF患者,较常规肾素血管紧张素系统抑制剂治疗进一步改善了患者心脏结构和患者活动耐量,安全性较好。

Objective To observe the effects of sacubitril valsartan on cardiac structure and activity tolerance in patients of heart failure with middle range ejection fraction(HFmrEF)with coronary heart disease.Methods Eighty-seven HFmrEF patients with coronary heart disease in our hospital from March 2021 to March 2022 were selected as the study objects.Among them,43 patients were treated with sakubatrol/valsartan,and 44 patients were treated with renin angiotensin system inhibitor as control group.The changes of cardiac structure and the improvement of activity tolerance were observed in 2 groups after 1 year of treatment.Results Compared with before treatment,6 min after treatment,the walking distance of two groups was longer,the inner diameter of left atrium and left ventricle was reduced,the level of amino terminal brain natriuretic peptide precursor(NT-proBNP)was lower,and the score of Kansas Cardiomyopathy Questionnaire(KCCQ)was higher(P<0.05).Compared with the control group,the treatment group had longer walking distance and smaller left ventricular diameter 6 min after treatment(P<0.05).Conclusion Compared with conventional RASI,sacubitril valsartan can further improve the cardiac structure and activity tolerance of patients with HFmrEF in coronary heart disease.