沙库巴曲缎沙坦治疗左心室射血分数降低心力衰竭患者的临床疗效观察  

The efficiency of Sacubitril/Valsartan therapy in patients with heart failure with reduced ejection fraction

作　　者：普顺华[1] 关英霞[1] 杨志刚[1] 郑甲林[1] 陶四明[1] 韩明华[1] PU Shun-hua;GUAN Ying-xia;YANG Zhi-gang;ZHENG Jia-lin;TAO Si-ming;HAN Ming-hua(Department of Cardiology, Yunnan No.2 People's Hospital, Kunming 650021, China)

机构地区：[1]云南省第二人民医院心内科,云南省昆明市650021

出　　处：《中国心血管病研究》2019年第3期266-269,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的观察沙库巴曲颂沙坦治疗左心室射血分数降低心力衰竭患者的临床疗效。方法选取云南省第二人民医院心内科2017年11月至2018年4月收治的左心室射血分数降低心力衰竭患者180例,随机分为观察组和对照组各90例。两组患者均给予标准化抗心衰治疗,观察组在标准化抗心衰治疗基础上加用沙库巴曲绷沙坦,连续治疗6个月。记录两组用药前后左心室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)、左心室收缩末期内径(left ventricular end-systolic diameter,LVESD)、左心室射血分数(left ventricular ejection fraction,LVEF)、血浆氨基末端脑钠肽前体(N-terminal pro brain natriuretic peptide, NT-proBNP)、6min步行试验(six-minutes walk test, 6MWT)和明尼苏达心衰量表评分(Minnesota heart failure quality of life, MHFQL)。并记录研究期间住院次数、每次住院天数及不良反应。结果沙库巴曲颂沙坦治疗6个月后与对照组比较,患者LVEDD.LVESD相比未见统计学差异[(54.83±6.92)mm比(55.47土 6.41)mm,(39.76±5.05)mm 比(41.02±6.80)mm,P>0.05],但LVEF增加[(48.98±7.24)%比(42.63±7.07)%,P< 0.01 ],NT-proBNP[(395.76±48.70)pg/ml 比(678.89±80.63)pg/ml,P<0.05]和 MHFQL 降低[(15.41±3.70)比(19.04±6.03),P<0.01],6min 步行距离延长[(350.39±33.79)m 比(300.22±30.18)m,P<0.05],住院次数减少[(1.4U0.58)次比(1.77±0.75)次/<0.05],平均住院天数缩短[(9.76±2.12)d 比(13.14±3.10)d,P<0.05],药物不良反应发生少。结论沙库巴曲绷沙坦治疗左心室射血分数降低心力衰竭患者有效安全。Objective To evaluate the efficacy and safety of administering Sacubitril / Valsartanin in patients with heart failure with reduced ejection fraction (HFrEF). Methods 180 cases of the HFrEF in the department of cardiology of Yunnan No.2 People's Hospital from November 2017 to April 2018 were randomized into the observation group and control group, each of which had 90. All patients were treated with routine anti-heart failure treatment. The observation group was treated with Sacubitril / Valsartan on the basis of routine treatment. All patients were treated for 6 months. Left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter(LVESD), left ventricular ejection fraction(LVEF), plasma N-terminal pro brain natriuretic peptide (NT-proBNP), six-minute walk test(6MWT)and Minnesota heart failure quality of life (MHFQL) were recorded before and after treatment in both groups. The times of hospitalizations, average hospital stays and adverse reactions were recorded during the study period. Results Compared with the control group, no significant differences were found in LVEDD and LVESD [(54.83±6.92)mni vs.(55.47±6.41) mm and(39.76±5.05)mm vs.(41.02±6.80)mm, P>0.05]. The observation group showed significantly decreased levels of NT-proBNP [(395.76±48.70)pg/ml vs.(678.89±80.63)pg/ml, P<0.05], MHFQL[(15.41±3.70)vs.(19.04±6.03), P<0.01] and LVEF increased [(48.98±7.24)% vs.(42.63±7.07)%, P<0.01] and 6-minute walking distance increased [(350.39±33.79) m vs.(300.22±30.18)m, P<0.05]. The number of hospital stay was decreased [(1.41±0.58) times vs.(1.77±0.75)times, P<0.05] and the average length of hospitalization was shortened [(9.76±2.12)days vs.(13.14±3.10)days, P<0.05];and the adverse drug reaction was less. Conclusion The cardiac function of the HFrEF was significantly improved by Sacubitril/Wsartan and the safety was good.

关 键 词：沙库巴曲颌沙坦 心力衰竭 射血分数 心功能 

分 类 号：R541.6[医药卫生—心血管疾病]