沙库巴曲缬沙坦治疗扩张型心肌病心力衰竭的疗效  

Therapeutic Effect of Sacubitri/Valsartan on Heart Failure in Patients with Dilated Cardiomyopathy

作　　者：章体玲[1] 张伟华[1] 罗庆祎[2] 夏洪颖[3] 鲁一兵[1] ZHANG Ti-ling;ZHANG Wei-hua;LUO Qing-yi;XIA Hong-ying;LU Yi-bing(Dept.of Cardiology,Yan’an Hospital of Kunming Medical University,Yunnan Cardiovascular Hospital,Kunming Yunnan 650051,China;Echo Room,Yan’an Hospital of Kunming Medical University,Yunnan Cardiovascular Hospital,Kunming Yunnan 650051,China;Dept.of Pharmacy,Yan’an Hospital of Kunming Medical University,Yunnan Cardiovascular Hospital,Kunming Yunnan 650051,China)

机构地区：[1]昆明医科大学附属延安医院,云南心血管病医院心内科,云南昆明650051 [2]昆明医科大学附属延安医院,云南心血管病医院心超室,云南昆明650051 [3]昆明医科大学附属延安医院,云南心血管病医院药学部,云南昆明650051

出　　处：《昆明医科大学学报》2020年第3期91-95,共5页Journal of Kunming Medical University

基　　金：云南省高层次卫生技术人才培养专项计划基金资助项目(L-201625)。

摘　　要：目的对比沙库巴曲缬沙坦与缬沙坦治疗扩张型心肌病心力衰竭患者的临床效果。方法选择2017年10月至2018年9月昆明医科大学附属延安医院心内科收治的扩张型心肌病心力衰竭患者95例。随机分为观察组(57例)和对照组(38例)。患者入院后均给予常规抗心衰治疗,在此基础上对照组给予缬沙坦,观察组予以沙库巴曲缬沙坦钠片。比较两组患者治疗后1月、6月、12月临床疗效、左心室舒张末期内径(LVDd)、左室射血分数(LVEF)及N末端脑钠肽前(NT-proBNP)、6 min步行试验(6MWT)。结果治疗1个月后两组左心室舒张末期内径(LVDd)、左室射血分数(LVEF)对比,差异无统计学意义(P>0.05);治疗6月、12月后二组患者左心室舒张末期内径缩小、左室射血分数增加,治疗前后两组患者组内比较差异具有统计学意义(P<0.05);观察组患者LVEF改善方面优于对照组,两组比较差异具有统计学意义(P<0.05)。尽管治疗时间不同,但两组患者治疗后NT-proBNP下降、6 min步行距离增加,治疗前后两组患者组内比较差异具有统计学意义(P<0.05)。结论与缬沙坦相比,短期运用沙库巴曲缬沙坦对于扩张型心肌病慢性心力衰竭患者而言不具优势,对于这个亚组治疗的获益来源于长期应用沙库巴曲缬沙坦。Objective To compare the clinical effects of Valsartan and Sacubitri/Valsartan in the treatment of heart failure in patients with dilated cardiomyopathy.Methods Ninety-five heart failure patients with dilated cardiomyopathy admitted to the hospital from October 2017 to September 2018 were selected.The patients were randomly divided into the observation group(n=57)and the control group(n=38).All patients were given conventional treatment for heart failure while the control group was given Valsartan and the observation group was given Sacubitri/Valsartan.The clinical efficacy of the two groups were compared at 1 month,6 months and 12 months after the treatment,as well as left ventricular end diastolic diameter(LVDd),left ventricular ejection fraction(LVEF),N-terminal brain natriuretic peptide precursor(NT-proBNP)and 6-minute walking test(6 MWT).Results After 1 month of treatment,the LVDd and LVEF of the two groups were not significantly different(P>0.05).LVDd was observed in both groups after 6 and 12 months and the diameter decreased and LVEF increased,and the difference between the two groups was significant(P<0.05).The LVEF improvement of the observation group was better than that of the control group(P<0.05).Although the treatment time was different,NT-proBNP decreased and the 6-minute walking distance increased after the treatment in the two groups and the difference between the two groups was significant(P<0.05).Conclusions Short-term use of Sacubitri/Valsartan does not take advantage over Valsartan for the chronic heart failure patients with dilated cardiomyopathy.The benefit comes from long-term application of Sacubitri/Valsartan.

关 键 词：沙库巴曲缬沙坦 扩张型心肌病 心力衰竭 

分 类 号：R542.2[医药卫生—心血管疾病]