沙库巴曲缬沙坦钠对老年慢性心力衰竭病人的影响

Effects of sacubitril valsartan sodium in elderly patients with chronic heart failure

目的探究沙库巴曲缬沙坦钠治疗老年慢性心力衰竭(心衰)病人的疗效和对整体功能的影响。方法回顾性选取2020年8月至2023年7月接受治疗的老年慢性心衰病人,根据治疗方式的不同分为观察组和对照组,各40例。对照组采取依那普利治疗,观察组采取沙库巴曲缬沙坦钠治疗。2组治疗前后均接受老年综合评估,检测肾功能指标、BNP并进行心脏超声检查,记录治疗期间2组心衰再住院率及不良反应发生率。结果治疗前2组老年综合评估组分、肾功能指标、BNP、心脏超声参数差异无统计学意义(P>0.05)。治疗后观察组日常生活能力(ADL)量表评分、Hamilton焦虑量表(HAMA)评分、肾功能指标均优于对照组,BNP水平低于对照组,左心室舒张末内径和左心室收缩末内径小于对照组,LVEF和左心室收缩分数高于对照组(P<0.05);观察组心衰再住院率高于对照组,不良反应发生率低于对照组(P<0.05);观察组Hamilton抑郁量表(HAMD)、MMSE和营养风险筛查(NRS2002)评分与对照组比较,差异无统计学意义(P>0.05)。结论沙库巴曲缬沙坦钠可以改善老年慢性心衰病人心肾功能,提高ADL,改善焦虑情绪,降低心衰再住院率,且安全性高。

Objective To analyze the effects of sacubitril valsartan sodium on the efficacy and overall function in the elderly patients with chronic heart failure(CHF).Methods A retrospective analysis was conducted in 80 patients with CHF from August 2020 to July 2023.These patients were divided into two groups according to the treatment methods,with 40 patients in each group.The control group was treated with enalapril,whereas the observation group was treated with sacubitril valsartan sodium.Before and after treatment,the scores of comprehensive geriatric assessment(CGA),the levels of renal function indicators,B-type natriuretic peptide(BNP)and echocardiography parameters were detected and compared between the two groups,and rehospitalization rate due to heart failure and the incidence rate of adverse reactions during treatment were recorded and compared between the two groups.Results Before treatment,there were no significant differences between the two groups in the scores of CGA,and the levels of renal function indicators,BNP and echocardiography parameters(P>0.05).After treatment,the scores of Activity of Daily Living scale and Hamilton Anxiety Scale and the levels of renal function indicators in the observation group were better than those in the control group.The levels of BNP,left ventricular end-diastolic diameter(LVEDD)and left ventricular end-systolic diameter(LVESD)were significantly lower than those in the control group(P<0.05),while the levels of left ventricular ejection fraction(LVEF)and left ventricular fraction shortening(LVFS)were significantly higher than those in the control group(P<0.05).The rate of heart failure rehospitalization and the incidence rate of adverse reactions were significantly lower in the observation group than those in the control group(P<0.05).There were no differences in the scores of Mini-Mental State Examination,Hamilton Depression Scale and Nutrition Risk Screening 2002 between the two groups(P>0.05).Conclusions During the treatment period,sacubitril valsartan sodium can safely improve cardiac and renal function and daily living ability,reduce anxiety and the rehospitalization rate in the elderly patients with CHF.