沙库巴曲缬沙坦治疗维持性血液透析合并射血分数保留性心力衰竭患者的效果

Effect of Sacubactril Valsartan on Maintenance Hemodialysis Patients with Ejection Fraction Preserving Heart Failure

目的:观察沙库巴曲缬沙坦在维持性血液透析合并射血分数保留性心力衰竭患者中的应用效果。方法:研究对象为2021年10月—2022年10月萍乡市人民医院收治的60例维持性血液透析合并射血分数保留性心力衰竭患者,采用随机数字表法分为治疗组和对照组,每组30例。治疗组给予酒石酸美托洛尔+沙库巴曲缬沙坦片,对照组给予酒石酸美托洛尔+氯沙坦钾片。对两组患者的血钙、血磷,N末端B型利钠肽原(NT-proBNP)、NYHA心功能分级、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、不良反应及主要不良心脏事件(MACEs)的发生情况进行分析。结果:治疗后,两组血磷、血钙水平比较,差异均无统计学意义(P>0.05);与治疗前比较,两组治疗后NT-proBNP水平均下降且治疗组水平更低,差异均有统计学意义(P<0.05)。治疗组治疗后NYHA心功能分级优于对照组,差异有统计学意义(P<0.05)。与治疗前比较,两组治疗后LVEDD、LVESD水平均下降且治疗组水平均更低,两组治疗后LVEF水平均上升且治疗组水平更高,差异均有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05);治疗组MACEs发生率低于对照组,差异有统计学意义(P<0.05)。结论:沙库巴曲缬沙坦对维持性血液透析合并射血分数保留性心力衰竭患者的心功能改善效果显著,同时具有较高的安全性。

Objective:To observe the effect of Sacubactril Valsartan in maintenance hemodialysis patients with heart failure with preserved ejection fraction.Method:The research objects were 60 maintenance hemodialysis patients with ejection fraction preserving heart failure who were admitted to Pingxiang People's Hospital from October 2021 to October 2022.They were randomly divided into treatment group and control group,with 30 cases in each group.The treatment group was given Metoprolol Tartrate+Sacubitril Valsartan Tablets,while the control group was given Metoprolol Tartrate+Losartan Potassium Tablets.The blood calcium,blood phosphorus,N-terminal B-type natriuretic peptide(NT-proBNP),NYHA cardiac function grade,left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),adverse reactions and major adverse cardiac events(MACEs)of the two groups were analyzed.Result:After treatment,there were no significant differences in blood phosphorus and calcium levels between the two groups(P>0.05).Compared with those before treatment,the levels of NT-proBNP in the two groups decreased after treatment,and the level in the treatment group was lower,with statistical significance(P<0.05).After treatment,the NYHA cardiac function grade of the treatment group was better than that of the control group,the difference was statistically significant(P<0.05).Compared with those before treatment,LVEDD and LVESD levels decreased in both groups after treatment and those were lower in the treatment group;LVEF levels increased in both groups after treatment and that is higher in the treatment group,with statistical significance(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The incidence of MACEs in treatment group was lower than that in control group,the difference was statistically significant(P<0.05).Conclusion:Sacubactril Valsartan has a significant effect on the improvement of cardiac function in maintenance hemodialysis patients with ejection fraction preservation heart failure,and has a high safety.