沙库巴曲缬沙坦用于血液透析患者心衰治疗的临床价值分析

Analysis of the Clinical Value of Sacubitril Valsartan for the Treatment of Heart Failure in Hemodialysis Patients

目的 研究沙库巴曲缬沙坦用于血液透析患者心衰治疗的临床效果。方法 方便选取2021年1月—2022年12月福建省龙岩人民医院收治的106例血液透析合并心衰患者为研究对象,采用随机数表法分组,每组53例。对照组采用贝那普利治疗,观察组采用沙库巴曲缬沙坦治疗。对比两组心肌损伤情况、心率和呼吸频率指标、心脏超声指标、心功能指标、肾功能指标、不良事件情况。结果 观察组氨基末端脑利钠肽前体(amino-terminal brain natriuretic peptide precursor,NT-proBNP)为(308.59±48.76)ng/L、心肌肌钙蛋白T(cardiac troponin T,cTnT)为(77.24±8.15)ng/L,均低于对照组,差异有统计学意义(t=24.270、7.581,P<0.001)。观察组心率、呼吸频率、左心室收缩末期内径(left ventricular end-systolic dimension,LVESD)、左心室舒张末期内径(left ventricular end diastolic dimension,LVEDD)、尿素氮、肌酐,均低于对照组,差异有统计学意义(P<0.001)。观察组左心室射血分数(left ventricular ejection fraction,LVEF)、每搏输出量、心输出量、6 min步行距离,高于对照组,差异有统计学意义(P<0.001)。观察组不良事件总发生率低于对照组,差异有统计学意义(P<0.05)。结论 沙库巴曲缬沙坦用于血液透析患者心衰治疗的临床效果显著优于贝那普利治疗。

Objective To study the clinical effect of sacubitril valsartan used in the treatment of heart failure in hemodialysis patients.Methods A total of 106 hemodialysis patients with heart failure admitted to Longyan People's Hospital of Fujian Province from January 2021 to December 2022 were conveniently selected as the research objects,and they were divided into two groups by random number table method,with 53 cases in each group.The control group was treated with benazepril,and the observation group was treated with sacubitril valsartan.The myocardial injury,heart rate and respiratory frequency index,cardiac ultrasound index,cardiac function index,renal function index and adverse events were compared between the two groups.Results The levels of amino-terminal brain natriuretic peptide precursor (NT-proBNP) and cardiac troponin T (cTnT) in the observation group were (308.59±48.76) ng/L and (77.24±8.15) ng/L,which were lower than those in the control group,and the differences were statistically significant (t=24.270,7.581,P<0.001).The heart rate,respiratory rate,left ventricular end-systolic dimension (LVESD),left ventricular end diastolic dimension (LVEDD),urea nitrogen and creatinine in the observation group were lower than those in the control group,and the difference was statistically significant (P<0.001).The left ventricular ejection fraction(LVEF),stroke volume,cardiac output and 6 min walking distance in the observation group were higher than those in the control group,and the differences were statistically significant (P<0.001).The total incidence of adverse events in the observation group was lower than that in the control group,the difference was statistically significant (P<0.05).Conclusion The clinical effect of sacubitril valsartan for heart failure treatment in hemodialysis patients is significantly better than that of benazepril treatment.