沙库巴曲缬沙坦钠对慢性心力衰竭患者左室舒张末内径的影响分析

Influence of sakubatril-valsartan sodium on left ventricular end-diastolic diameter in patients with chronic heart failure

目的观察沙库巴曲缬沙坦钠对慢性心力衰竭患者左室舒张末内径变化的影响分析。方法选取2020年2月至2023年6月于安徽淮南朝阳医院心血管内科收治的慢性心力衰竭患者90例,采用随机数字表法分为常规组和诺新妥组,每组各45例。常规组给予常规治疗,诺新妥组在常规组基础上给予沙库巴曲缬沙坦钠治疗。比较两组治疗前后血清因子[白介素-10(IL-10)、C反应蛋白(CRP)、N末端脑钠肽前体(NT-proBNP)、肿瘤坏死因子-α(TNF-α)]、6 min步行试验、左心室重构指标[左室射血分数(LVEF)、左心室舒张末期内径(LVEDd)、左心房前后径(LAAPd)、左心室舒张末期容积(LVEDV)、心肌质量指数(LVMI)、左心室收缩末期容积(LVESV)]、左室心肌做功差异。结果两组治疗前IL-10、NT-proBNP及6 min步行试验比较,差异无统计学意义(P>0.05)。治疗后比较,两组血清因子均降低,6 min步行距离均增加,诺新妥组变化更为显著(P<0.05)。两组治疗前左心室重构指标、左室心肌做功指标比较,差异无统计学意义(P>0.05)。治疗后两组LVEF、左室心肌整体做功指数(GWI)、整体有用功(GCW)、整体做功效率(GWE)比较均升高,诺新妥组升高更为明显,LVEDd、LAAPd、LVEDV、LVMI、LVESV和左室心肌整体无用功(GWW)降低,诺新妥组降低更为明显(P<0.05)。结论沙库巴曲缬沙坦钠治疗慢性心力衰竭可抑制左心室重构,改善左室心肌做功,提高患者的运动耐力。

Objective To observe the influence of sakubatril-valsartan sodium on changes of left ventricular end-diastolic diameter(LVEDd)in patients with chronic heart failure(CHF).Methods CHF patients(n=90)were chosen from Department of Cardiovascular Medicine in Huainan Chaoyang Hospital of Anhui Province from Feb.2020 to June 2023,and they were divided routine group and Entresto group(each n=45).The routine group was treated with routine therapy,and Entresto group was additionally treated with sakubatril-valsartan sodium.The differences in serum factors[interleukin-10(IL-10),C-reactive protein(CRP),N-terminal pro-brain natriuretic peptide(NT-proBNP),tumor necrosis factor-α(TNF-α)],6-minute walk test(6MWT),and indexes of left ventricular remodeling[left ventricular ejection fraction(LVEF),LVEDd,left atrial anteroposterior diameter(LAAPd),left ventricular end-diastolic volume(LVEDV),left ventricular mass index(LVMI),left ventricular end-systolic volume(LVESV),left ventricular myocardial performance]were compared between 2 groups before and after treatment.Results The differences in IL-10,NT-proBNP and 6MWT had no statistical significance between 2 groups before treatment(P>0.05).The levels of serum factors decreased,and 6MWT increased in 2 groups after treatment,which was more significant in Entresto group(P<0.05).The differences in indexes of left ventricular remodeling and left ventricular myocardial performance had no statistical significance between 2 groups before treatment(P>0.05).The levels of LVEF and left ventricular global work index(GWI),global effective work(GCW)and global work efficiency(GWE)increased,and LVEDd,LAAPd,LVEDV,LVMI,LVESV and left ventricular global ineffective work(GWW)decreased in 2 groups after treatment,which was more significant in Entresto group(P<0.05).Conclusion Sakubatril-valsartan sodium can inhibit left ventricular remodeling,improve left ventricular myocardial performance and promote exercise endurance in CHF treatment.