沙库巴曲缬沙坦钠对慢性心力衰竭患者血管内皮功能和心率变异的影响

Influence of sacubitril valsartan sodium on vascular endothelial function and heart rate variability in patients with chronic heart failure

目的:探究沙库巴曲缬沙坦钠对慢性心力衰竭患者血管内皮功能和心率变异的影响。方法:回顾性分析2022年1月至2023年10月我院收治的慢性心力衰竭患者68例,按照治疗方法不同分为A组(沙库巴曲缬沙坦钠,n=35)和B组(缬沙坦,n=33)。比较两组慢性心力衰竭患者治疗前、治疗1 m后血管内皮功能(一氧化氮(Nitric oxide,NO)、内皮素1(Endothelin-1,ET-1)和血栓素2(Thromboxane 2,TVB2)),血压变异性(24 h收缩压标准差(24 h Standard deviation of systolic blood pressure,24 h SSD)、24 h舒张压标准差(24 h Standard deviation of diastolic blood pressure,24 h DSD)、日间收缩压标准差(Standard deviation of daytime systolic blood pressure,dSSD)、日间舒张压标准差(Standard deviation of diastolic blood pressure,dDsD)、夜间收缩压标准差(Standard deviation of nocturnal systolic blood pressure,nssD)和夜间舒张压标准差(Standard deviation of nocturnal diastolic blood pressure,nDsD),心肌酶谱(肌酸激酶(Creatine kinase,CK)、乳酸脱氢酶(Lactate dehydrogenase,LDH)、天门冬氨酸氨基转移酶(Aspartate aminotransferase,AST)、肌钙蛋白I(Troponin I,cTnI)水平,统计治疗不良反应。结果:治疗后,A组ET-1、TVB2水平均低于B组,NO水平高于B组(均P<0.05)。治疗后,A组慢性心力衰竭患者24 hSSD、24h DSD、dSSD、dDSD、nSSD和nDSD均低于B组(均P<0.05)。A组治疗后CK、LDH、AST和cTnI水平均低于B组(均P<0.05)。A组和B组水肿、低血压、尿频等不良反应总发生率分别为8.57%和15.15%(χ^(2)=0.709,P>0.05)。结论:沙库巴曲缬沙坦钠应用于治疗慢性心力衰竭能有效改善患者血管内皮功能、血压变异性和心肌酶谱,且安全性良好。

Objective:To explore the influence of sacubitril valsartan sodium on vascular endothelial function and heart rate variability in treating patients with chronic heart failure(CHF).Methods:All 68 patients with CHF in the hospital were retrospectively analyzed from January 2022 to October 2023,and were divided into group A(sacubitril valsartan sodium,n=35)and group B(valsartan,n=33)according to different treatment methods.The vascular endothelial function[nitric oxide(NO),endothelin-1(ET-1),thromboxane 2(TVB2)],blood pressure variability(24 hours standard deviation of systolic blood pressure(24 h SSD),24 hours standard deviation of diastolic blood pressure(24 h DSD),standard deviation of daytime systolic blood pressure(dSSD),standard deviation of daytime diastolic blood pressure(dDSD),standard deviation of nocturnal systolic blood pressure(nSSD),standard deviation of nocturnal diastolic blood pressure(nDSD)],myocardial enzymes[creatine kinase(CK),lactate dehydrogenase(LDH),aspartate aminotransferase(AST),cardiac troponin I(cTnI)]were compared between groups of patients with CHF before treatment and after 1 month of treatment.The adverse reactions of treatment were counted.Results:The levels of ET-1 and TVB2 in group A after treatment were lower than those in group B while the level of NO was higher than that in group B(all P<0.05).After treatment,the 24 h SSD,24 h DSD,dSSD,dDSD,nSSD,and nDSD of patients with CHF in group A were lower than those in group B(all P<0.05).The levels of CK,LDH,AST,and cTnI in group A after treatment were lower than those in group B(all P<0.05).The total incidence rates of adverse reactions such as edema,hypotension,and urinary frequency in group A and group B were 8.57%and 15.15%(χ^(2)=0.709,P>0.05).Conclusion:Sacubitril valsartan sodium can effectively improve the vascular endothelial function,blood pressure variability and myocardial enzymes in patients with chronic heart failure,and it has good safety.