沙库巴曲缬沙坦联合冻干重组人脑利钠肽治疗心力衰竭的疗效研究

Study on the efficacy of sacubitril/valsartan plus lyophilized recombinant human brain natriuretic peptide in the treatment of heart failure

目的分析沙库巴曲缬沙坦+冻干重组人脑利钠肽用于心力衰竭治疗的效果。方法取160例心力衰竭患者为观察对象,按照治疗方案不同作分组处理,分为参照组(n=80)、研究组(n=80)。参照组开展沙库巴曲缬沙坦药物治疗,研究组开展沙库巴曲缬沙坦+冻干重组人脑利钠肽治疗。比较两组心力衰竭患者的治疗效果、用药不良反应发生率及治疗前后心功能[每搏输出量(SV)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、心率(HR)]、生化指标[血浆N末端B型利钠肽前体(NT-proBNP)、醛固酮(ALD)、细胞间粘附分子-1(ICAM-1)、血肌酐]变化。结果研究组患者治疗总有效率97.50%较参照组的87.50%更高(P<0.05)。研究组患者用药不良反应发生率3.75%较参照组的15.00%更低(P<0.05)。治疗后,两组患者的LVEF、SV高于治疗前,HR、LVESD、LVEDD低于治疗前,且研究组患者LVEF(44.15±3.78)%、SV(55.23±4.56)ml较参照组的(38.12±3.25)%、(49.13±4.12)ml更高,HR(71.24±4.54)次/min、LVESD(43.12±2.75)mm、LVEDD(56.98±3.96)mm较参照组的(76.24±3.25)次/min、(46.96±2.89)mm、(60.12±4.28)mm更低(P<0.05)。治疗后,两组患者的NT-proBNP、ALD、ICAM-1低于治疗前(P<0.05);而血肌酐与治疗前相比无明显差异(P>0.05)。治疗后,研究组患者NT-proBNP、ALD、ICAM-1较参照组更低(P<0.05);而两组患者血肌酐组间对比,无明显差异(P>0.05)。结论沙库巴曲缬沙坦+冻干重组人脑利钠肽用于心力衰竭疾病治疗中,可提升疗效,降低药物不良反应发生率,并改善其心功能、生化指标状况。

Objective To analyze the effect of sacubitril/valsartan plus lyophilized recombinant human brain natriuretic peptide in the treatment of heart failure.Methods 160 patients with heart failure were enrolled in this study,the patients were divided into a reference group(n=80)and a study group(n=80)according to different treatment regimens.The patients in the reference group were treated with sacubitril/valsartan,while those in the study group were treated with sacubitril/valsartan plus lyophilized recombinant human brain natriuretic peptide.Both groups were compared in terms of therapeutic effects,adverse drug reactions,cardiac function[stroke volume(SV),left ventricular end systolic diameter(LVESD),left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),heart rate(HR)]and biochemical indexes[plasma N-terminal pro-B-type natriuretic peptide(NT-proBNP),aldosterone(ALD),intercellular adhesion molecule-1(ICAM-1),serum creatinine]before and after treatment.Results The total effective rate of the study group(97.50%)was higher than that of the reference group(87.50%)(P<0.05).The incidence of adverse drug reactions in the study group(3.75%)was lower than that in the reference group(15.00%)(P<0.05).After treatment,LVEF and SV in both groups were higher than those before treatment,while HR,LVESD and LVEDD were lower than those before treatment;the study group had LVEF of(44.15±3.78)%and SV of(55.23±4.56)ml,which were higher than(38.12±3.25)%and(49.13±4.12)ml in the reference group;the study group had HR of(71.24±4.54)beats/min,LVESD of(43.12±2.75)mm and LVEDD of(56.98±3.96)mm,which were lower than(76.24±3.25)beats/min,(46.96±2.89)mm and(60.12±4.28)mm in the reference group(P<0.05).After treatment,the levels of NT-proBNP,ALD and ICAM-1 in both groups were lower than those before treatment(P<0.05).There was no significant difference in serum creatinine before and after treatment(P>0.05).After treatment,NT-proBNP,ALD and ICAM-1 in the study group were lower than those in the reference group(P<0.05).There was no significant difference in serum creatinine between the two groups(P>0.05).Conclusion In the treatment of heart failure,sacubitril/valsartan+lyophilized recombinant human brain natriuretic peptide can improve the curative effect,reduce the incidence of adverse drug reactions,and improve the cardiac function and biochemical indexes.