沙库巴曲缬沙坦联用丹参川芎嗪改善慢性心力衰竭患者左心室功能和NT-proBNP、MMP-9水平  

Sacubitril-valsartan combined with Salvia miltiorrhiza-ligustrazine on left ventricular function and levels of NT-proBNP and MMP-9 in patients with chronic heart failure

作　　者：杨静 裴双义[2] 朱丹 郝建春 崔玉祥 马威[3] 郑川燕 吴峥 YANG Jing;PEI Shuang - yi;ZHU Dan;HAO Jian - chun;CUI Yu - xiang;MA Wei;ZHENG Chuan- yan;WU Zheng(Department of Cardiology,Tangshan Hongci Hospital,Tangshan HEBEI 063009,China;Department ofPsychiatric,the Fifth Hospital of Tangshan City,Tangshan HEBEI 063005,China;Department of Cardiology,Tangshan Worker Hospital,Tangshan HEBEI 063003,China;Beijing Institute of Cardio Pulmonary Vascular Diseases,Beijing Anzhen Hospital,Capital Medical University,BEIJING 100029,China)

机构地区：[1]唐山弘慈医院心内科,河北唐山063009 [2]唐山市第五医院精神科,河北唐山063005 [3]唐山工人医院心内科,河北唐山063003 [4]首都医科大学附属北京安贞医院北京市心肺血管疾病研究所,北京100029

出　　处：《中国新药与临床杂志》2019年第8期493-498,共6页Chinese Journal of New Drugs and Clinical Remedies

基　　金：2017年度医学科学研究重点课题计划项目（20171366）;北京市自然科学基金（7142048）

摘　　要：目的观察沙库巴曲缬沙坦联用丹参川芎嗪对慢性心力衰竭患者左心室功能和N末端脑钠肽前体(NT-proBNP)、基质金属蛋白酶9(MMP-9)水平的影响。方法慢性心力衰竭患者160例,随机分为贝那普利组(A组)、贝那普利联用丹参川芎嗪组(B组)、沙库巴曲缬沙坦组(C组)和沙库巴曲缬沙坦联用丹参川芎嗪组(D组),每组40例。用药方法为贝那普利10~20 mg,每日1次;丹参川芎嗪10 mL静脉滴注,每日1次;沙库巴曲缬沙坦100~200 mg,每日2次。检测各组治疗前及治疗6个月后血压、心率、肾功能、左室射血分数(LVEF)、超敏C反应蛋白(hs-CRP)、NT-proBNP和MMP-9等指标,并记录不良反应、不良事件及终点事件发生情况。结果与治疗前比较,治疗6个月后4组患者肾功能和空腹血糖均无显著变化(P>0.05),LVEF显著升高(P<0.05),hs-CRP、NT-proBNP和MMP-9水平显著下降(P<0.05),C组和D组心率显著减慢(P<0.05)。与A组和B组比较,C组和D组治疗6个月后心率减慢,LVEF显著升高(P<0.05),hs-CRP、NT-proBNP、MMP-9水平显著下降(P<0.05);D组较C组hs-CRP、NT-proBNP、MMP-9降低更为显著(P<0.05)。4组间不良反应发生率无显著差异(P>0.05)。D组心血管死亡、全因死亡、心力衰竭住院例次显著少于B组(P<0.05),与C组比较无显著差异(P>0.05)。结论沙库巴曲缬沙坦联用丹参川芎嗪可显著改善慢性心力衰竭患者左心室功能,降低NT-proBNP、MMP-9水平,疗效和安全性优于贝那普利单用或联用丹参川芎嗪。AIM To explore the influence of sacubitril-valsartan combined with Salvia miltiorrhiza-ligustrazine on left ventricular function and the levels of N-terminal B-type natriuretic peptide(NT-proBNP)and matrix metalloproteinase-9(MMP-9)in patients with chronic heart failure.METHODS A total of 160 patients with chronic heart failure were randomly divided into four groups:benazepril group(group A),benazepril combined with Salvia miltiorrhiza-ligustrazine group(group B),sacubitril-valsartan group(group C)and sacubitril-valsartan combined with Salvia miltiorrhiza-ligustrazine group(group D),40 patients in each group.The regimen was bennazepril 10-20 mg,qd,po;Salvia miltiorrhiza-ligustrazine 10 mL,qd,ivgtt;and sacubitril-valsartan 100-200 mg,bid,po.The renal function,blood pressure,heart rate,high sensitive C reactive protein(hs-CRP),NT-proBNP,MMP-9 and left ventricular ejection fraction(LVEF)between the four groups were compared before treatment and 6 months after treatment.The rate of adverse reactions and the occurrence of adverse events and endpoints were compared either.RESULTS Compared with before treatment,the renal function and blood glucose in four groups were not significantly different(P>0.05),LVEF were increased significantly(P<0.05)and the levels of hs-CRP,NT-proBNP and MMP-9 were decreased significantly by the followed up after six months(P<0.05).Heart rate was decreased significantly in the group C and group D(P<0.05)after six months,compared with group A and group B,heart rate and the levels of hs-CRP,NT-proBNP and MMP-9 were significantly decreased and LVEF was significantly increased in the group C and group D(all P<0.05).The levels of hs-CRP,NT-proBNP and MMP-9 in the group D were significantly lower than those in the group C.There were no significant differences in the incidence of adverse reactions among the four groups(P>0.05).The cardiovascular mortality and all-cause mortality in the group D was significantly lower than these in the group B(P>0.05),and there was no significant difference compared w

关 键 词：心力衰竭 沙库巴曲缬沙坦 丹参川芎嗪 贝那普利 利钠肽 脑 基质金属蛋白酶9 心室功能 左 

分 类 号：R972[医药卫生—药品]