实用医学杂志 ›› 2021, Vol. 37 ›› Issue (11): 1461-1465.doi: 10.3969/j.issn.1006⁃5725.2021.11.018

• 药物与临床 • 上一篇    下一篇

沙库巴曲缬沙坦治疗临床阶段舒张性心力衰竭的临床分析

彭锦, 张缤月, 戴慧勇, 曹佳, 毛亮, 朱玲玲, 姚贤萍, 张园园   

  1. 1 中国人民解放军联勤保障部队第928医院心内科(海口 571159);2 海南医学院第一附属医院心内科 (海口 570102);3 急救与创伤研究教育部重点实验室,急诊创伤学院,海南医学院(海口 571199)

  • 出版日期:2021-06-10 发布日期:2021-06-10
  • 通讯作者: 张园园 E⁃mail:yzhang143@bwh.harvard.edu
  • 基金资助:
    急救与创伤研究教育部重点实验室(海南医学院)开放课题基金(编号:Grant. KLET⁃202019);海南省自然基金(编号:
    819QN366);海南省科协青年科技英才项目(编号:QCXM201901)

R541.9 Clinical analysis of Sacubitril ⁃ Valsartan in patients with clinical diastolic heart failure 

PENG Jin, ZHANG Binyue,DAI Huiyong,CAO Jia,MAO Liang,ZHU Lingling,YAO Xianping,ZHANG Yuanyuan. *   

  1. De-partment of Cardiology,the 928th Hospital of the Joint Logistic Support Force of the Chinese People′ s Liberation Army,Haikou 571159,China 

  • Online:2021-06-10 Published:2021-06-10
  • Contact: Zhang Yuanyuan E⁃mail:yzhang143@bwh.harvard.edu

摘要:

目的 分析沙库巴曲缬沙坦治疗临床阶段舒张性心力衰竭的有效性及安全性。方法 2019 6 月至 2020 6 月在第九二八医院及海南医学院第一附属医院心内科就诊的舒张性心力衰竭患者 113 例,随机分为对照组 57 例和试验观察组 56 例。对照组予常规抗心衰治疗,观察组将对照组中 ARB/ACEI 替换为沙库巴曲缬沙坦。随访前比较两组的临床资料,随访 6 个月后分析两组的血压、6 min 行试验 NT⁃proBNP、AST、ALT、SCr 及血钾水平;并比较了两组的心超相关指标及再住院率、MACE 发生率、 不良反应发生率。结果 治疗 6 个月后,观察组的 6MW、NT⁃proBNP、LVEDVI、LVESVI E/e′结果较对照 组明显改善,且对肾脏的保护作用优于对照组;观察组再住院率、不良反应发生率明显低于对照组,而两组间的血压、肝功能、血钾、EF、LAVI 水平及 MACE 发生率差异无统计学意义。结论 沙库巴曲缬沙坦治 疗临床阶段舒张性心力衰竭安全、有效。

关键词:

沙库巴曲缬沙坦, 舒张性心力衰竭, NT?proBNP, 二尖瓣E/e′, 药物疗效性评价

Abstract:

Objective To observe and analyze the effectiveness and safety of sacubitril⁃valsartan for dia⁃ stolic heart failure. Methods A total of 113 participants confirmed with diastolic heart failure and ejection fraction of 50% or more from the cardiovascular department of the 928th Hospital of the Chinese People′s Liberation Army and the First Affiliated Hospital of Hainan Medical University from June,2019 to June,2020,were selected and randomly assigned to control group(n = 57)andexperimental observation group(n = 56). The control group received conventional anti ⁃ heart failure therapy. The treatment plan of the observation group replaced the ARB/ ACEI with sacubitril⁃valsartan instead. During the 6 month of observation and regular follow⁃up,we collected the baseline characteristics and clinical information before the research and analyzed the levels of blood pressure 6⁃min walking test(6MW)results,serum N⁃terminal pro⁃brain natriuretic peptide(NT⁃proBNP),AST,ALT SCr,and potassium levels of the two groups. Meanwhile,cardiac ultrasonography related index of the two groups were tested and analyzed. Additionally,readmission rate,MACE and adverse reactions rate of the two groups were collected and compared. Results The clinical effective rate of the observation group was significantly higher than that of the control group. Greater reductions from baseline were found in patients who received sacubitril⁃ valsartan,including 6MW,NT⁃proBNP,LVEDVI,LVESVI,and mitral E/e′ ratio. The effectiveness of the drugs and the protection of the kidneys in the experimental group were also better than those in the control group. Readmission rate and adverse reactions rate were decreased in the experimental group. However,there were no statis⁃ tically differences in the blood pressure,liver function,serum potassium,EF%,LAVI levels and MACE between the two groups. Conclusions Sacubitril ⁃ Valsartan was effective and safe in the treatment of. clinical diastolic heart failure. 

Key words:

sacubitril?Valsartan, diastolic heart failure, NT?proBNP, mitral E/e′ ratio, drug effi? cacy evaluation