沙库巴曲缬沙坦钠治疗尿毒症血液透析合并心力衰竭患者的效果

Effects of Sacubitril valsartan sodium in treatment of uremic hemodialysis patients with heart failure

目的:观察尿毒症血液透析合并心力衰竭患者应用沙库巴曲缬沙坦钠治疗的效果。方法:选取2020年6月至2023年3月该院收治的76例尿毒症血液透析合并心力衰竭患者进行前瞻性研究,依据随机分层法划分为对照组与观察组各38例。对照组采用常规治疗,观察组在对照组基础上联合沙库巴曲缬沙坦钠治疗。比较两组临床疗效,治疗前后心功能指标[左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、N-末端脑钠肽前体(NT-proBNP)]水平、肾功能指标[血尿素氮(BUN)、血肌酐(Scr)、同型半胱氨酸(Hcy)]水平,以及不良反应发生率。结果:观察组治疗总有效率为94.74%(36/38),高于对照组的78.95%(30/38),差异有统计学意义(P<0.05);与治疗前相比,两组治疗后LVESD、LVESV、NT-proBNP、Scr、BUN、Hcy水平均降低且观察组比对照组更低,LVEF水平均上升且试验组比对照组更高,差异有统计学意义(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)。结论:针对尿毒症血液透析合并心力衰竭患者采用沙库巴曲缬沙坦钠治疗效果确切,不仅有助于患者心功能的改善,还能够降低肾功能指标水平。

Objective:To observe effects of Sacubitril valsartan sodium in treatment of uremic hemodialysis patients with heart failure.Methods:A prospective study was conducted on 76 uremia hemodialysis patients with heart failure admitted to this hospital from June 2020 to March 2023.According to the random number table method,they were divided into control group and observation group,38 cases in each group.The control group was treated with conventional treatment,while the observation group was treated with Sacubitril valsartan sodium on the basis of that of the control group.The clinical efficacy,the cardiac function indexes[left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),N-terminal pro-brain natriuretic peptide(NT-pro BNP)]levels and the renal function indexes[blood urea nitrogen(BUN),serum creatinine(Scr),homocysteine(Hcy)]levels before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 94.74%(36/38),which was higher than 78.95%(30/38)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of LVESD,LVESV,NT-proBNP,Scr,BUN and Hcy in the two groups were lower than those before the treatment,and those in the observation group were lower than those in the control group;the LVEF levels of the two groups were higher than those before the treatment,and that in the observation group was higher than that in the control group;and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:On the basis of the conventional treatment,Sacubitril valsartan sodium in the treatment of the uremic hemodialysis patients with heart failure can improve the total effective rate of treatment,improve the levels of cardiac function indexes,and reduce the levels of renal function indexes.Moreover,it is superior to single conventional treatment.