沙库巴曲缬沙坦对失能老年慢性心力衰竭患者心脏功能、心肌损伤标志物及MACE发生率的影响

Effects of Sacubitril Valsartan on Cardiac Function,Myocardial Injury Markers and the Incidence of MACE in Disabled Elderly Patients with Chronic Heart Failure

目的:探究沙库巴曲缬沙坦对失能老年慢性心力衰竭(chronic heart failure,CHF)患者心脏功能、心肌损伤标志物及主要不良心血管事件(major adverse cardiovascular events,MACE)发生率的影响。方法:选取2022年1—6月于昆明三一一医院内三科就诊的90例失能老年CHF患者作为研究对象,用简单随机化法分为观察组与对照组,每组45例。对照组采用常规治疗,观察组在此基础上予以沙库巴曲缬沙坦治疗。对比两组治疗前、治疗6个月后的心脏功能[心率(heart rate,HR)、心排血量(cardiac output,CO)、左心室射血分数(left ventricular ejection fraction,LVEF)、左心室收缩末期内径(left ventricular end-systolic diameter,LVESD)、左心室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)]、心肌损伤标志物[N-末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)、心肌肌钙蛋白I(cardiac troponin I,cTnI)、Ⅲ型前胶原氨基端肽(procollagenⅢN-terminal peptide,PⅢNP)]、运动耐力[6分钟步行试验(6 min walk test,6MWT)],记录两组MACE发生情况。结果:治疗6个月后,两组CO、LVEF均升高,观察组均高于对照组,6MWT距离均增加,观察组长于对照组,LVESD、LVEDD均减小,观察组均小于对照组,HR、NT-proBNP、cTnI、PⅢNP均降低,观察组均低于对照组,差异均有统计学意义(P<0.05)。两组MACE发生率比较,差异无统计学意义(P>0.05)。结论:沙库巴曲缬沙坦可显著改善失能老年CHF患者临床症状,缓解心肌损伤。

Objective:To explore the effects of Sacubitril Valsartan on cardiac function,myocardial injury markers and the incidence of major adverse cardiovascular events(MACE)in disabled elderly patients with chronic heart failure(CHF).Method:A total of 90 disabled elderly patients with CHF who were treated in Department of Internal MedicineⅢ,Kunming 311 Hospital from January to June 2022 were selected as the study objects,and were divided into observation group and control group by simple randomization method,with 45 cases in each group.The control group was treated with conventional treatment,and the observation group was treated with Sacubitril Valsartan on this basis.The cardiac function[heart rate(HR),cardiac output(CO),left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD)and left ventricular end-diastolic diameter(LVEDD)],myocardial injury markers[N-terminal pro-brain natriuretic peptide(NT-proBNP),cardiac troponin I(cTnI),procollagenⅢN-terminal peptide(PⅢNP)]and exercise tolerance[6 min walk test(6MWT)]were compared between the two groups before treatment and 6 months after treatment,and the occurrence of MACE in the two groups were recorded.Result:6 months after treatment,CO and LVEF were increased in both groups,those in the observation group were higher than those in the control group,the distance of 6MWT were increased,that in the observation group was longer than that in the control group,LVESD and LVEDD were decreased,those in the observation group were smaller than those in the control group,HR,NT-proBNP,cTnI and PⅢNP were decreased,and those in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of MACE between the two groups(P>0.05).Conclusion:Sacubitril Valsartan can significantly improve clinical symptoms and alleviate myocardial injury in disabled elderly patients with CHF.