小剂量沙库巴曲缬沙坦治疗心力衰竭合并慢性肾脏病1-3期患者的疗效及安全性

Efficacy and safety of low-dose sacubitril/valsartan in the treatment of heart failure patients with chronic kidney disease stages 1-3

目的探究与分析小剂量沙库巴曲缬沙坦治疗心力衰竭合并慢性肾脏病1-3期患者的疗效及安全性.方法采取随机数字表法对本院收治的心力衰竭合并慢性肾脏病1-3期患者80例分组,每组各40例,两组均采取常规治疗与沙库巴曲缬沙坦治疗,起始用药剂量为50mg,每日2次;连续治疗1-2周后对用药剂量进行调整,对照组所采取的剂量为25mg,每日2次,观察组维持剂量为50mg,每日2次,对比两组治疗前后心功能相关指标以及肾功能相关指标,同时对比两组安全性.结果与治疗前相比,两组治疗后LVEF值较高、LVESD值较低、6MWT值较高、NT-proBNP值较低,GFR值较高、Scr值较低、BUN值较低,差异有统计学意义(P<0.05).观察组治疗后与对照组治疗后LVEF值、LVESD值、6MWT值、NT-proBNP值、GFR值、Scr值及BUN值比较,差异无统计学意义(P>0.05).结论小剂量沙库巴曲缬沙坦治疗心力衰竭合并慢性肾脏病1-3期患者同样会获得相同的疗效,在改善心功能指标以及肾功能指标上均能获得可靠的效果,且不会增加不良反应,安全性较高.

Objective To investigate and analyze the efficacy and safety of low-dose sacubitril/valsartan in the treatment of heart failure patients with chronic kidney disease(CKD)stages 1-3.Methods Eighty patients with heart failure and CKD stages 1-3 were randomly divided into two groups of 40 each using a random number table method.Both groups received conventional treatment and sacubitril/valsartan treatment,starting with an initial dose of 50mg twice daily.After 1 to 2 weeks of continuous treatment,the dosage was adjusted:the control group received 25mg twice daily,while the observation group maintained 50mg twice daily.Cardiac function and renal function indicators were compared before and after treatment,as well as the safety between the two groups.Results Compared with pre-treatment,post-treatment levels in both groups showed significantly higher LVEF values,lower LVESD values,higher 6MWT values,lower NT-proBNP values,higher GFR values,lower Scr values,and lower BUN values(P<0.05).No significant differences were observed in the post-treatment comparison of LVEF,LVESD,6MWT,NT-proBNP,GFR,Scr,and BUN values between the observation and control groups(P>0.05).Conclusion Low-dose sacubitril/valsartan in the treatment of heart failure patients with CKD stages 1-3 achieves similar efficacy,reliably improving cardiac and renal function indicators without increasing adverse reactions.It ensuring high safety.