沙库巴曲缬沙坦钠对左心室射血分数保留心力衰竭患者的近期疗效  

Effect of sacubitril/valsartan in treatment of heart failure with preserved ejection fraction

作　　者：郝珍 李巍[2] 于洪伟[3] 江珊[3] Hao Zhen;Li Wei;Yu Hong Wei;Jiang Shan(Graduate School of Jinzhou Medical University,Jinzhou 121000,China;Department of Oncology,Jinzhou Central Hospital,Jinzhou 121000,China;Department of Cardiology,Jinzhou Central Hospital,Jinzhou 121000,China)

机构地区：[1]锦州医科大学研究生院,辽宁锦州121000 [2]锦州市中心医院肿瘤科,辽宁锦州121000 [3]锦州市中心医院心内科,辽宁锦州121000

出　　处：《临床荟萃》2020年第6期503-507,共5页Clinical Focus

基　　金：锦州市科学技术计划项目HER2阳性乳腺癌患者他莫昔芬耐药机制及其临床应用研究(17B1E37)。

摘　　要：目的观察沙库巴曲缬沙坦钠对左心室射血分数保留心力衰竭患者的临床疗效及短期预后的影响。方法2018年3月至2019年3月在辽宁省锦州市中心医院心内科就诊的左心室射血分数保留心力衰竭患者96例,随机分为观察组和对照组各48例。对照组给予基础抗心力衰竭治疗,包括休息、低盐低脂饮食及应用利尿剂、扩张血管药物、β受体阻滞剂、螺内酯及血管紧张素转化酶抑制剂(ACEI)/血管紧张素受体拮抗剂(ARB)类药物。观察组将基础抗心力衰竭治疗中使用的ACEI/ARB类药物替换为沙库巴曲缬沙坦钠片,两组均连续治疗6个月。比较两组临床疗效。结果治疗6个月后观察组临床总有效率明显高于对照组,93.33%(42/45)vs 76.08%(35/46)(P<0.05);两组治疗后NT-proBNP水平、6MWT距离均较治疗前改善,观察组比对照组改善更显著(P<0.05);观察组不良心血管事件发生率较对照组明显降低(P<0.05)。结论沙库巴曲缬沙坦钠可以明显改善左心室射血分数保留心力衰竭患者的心功能、提高活动耐力、减少不良心血管事件,提高临床疗效,且具有安全性。Objective To observe the clinical efficacy and short-term prognosis of sacubitril/valsartan on patients with heart failure with preserved left ventricular ejection fraction(LVEF).Methods Totally 96 patients with heart failure with preserved LVEF were selected from March 2018 to March 2019.They were randomly divided into observation group and control group with 48 cases in each group.The control group was given basic anti-heart failure treatment,including rest,low salt and low fat diet,diuretics,vasodilators,β-blockers,spironolactone and angiotensin converting enzyme inhibitor(ACEI)and angiotensin receptor antagonist(ARB)drugs.The observation group replaced the ACEI/ARB drugs used in basic anti-heart failure treatment with sacubitril/valsartan.All patients were treated continuously for 6 months.The clinical efficacy of two groups was compared.Results After 6 months of treatment,the total clinical effective rate in observation group 93.33%(42/45)was significantly higher than that in control group 76.08%(35/46)(P<0.05).Both NT-proBNP level and 6MWT distance in two groups were improved compared with those before treatment,and observation group had more obvious improvement than the control group(P<0.05).The incidence of adverse cardiovascular events in observation group was significantly lower than that in control group(P<0.05).Conclusion Sacubitril/valsartan can significantly strengthen the cardiac function,enhance the activity endurance,reduce adverse cardiovascular events,improve the clinical efficacy and safety in patients with heart failure with preserved LEVF.

关 键 词：沙库巴曲缬沙坦 心力衰竭 充血性 每搏输出量 利钠肽 脑 心脏功能试验 预后 

分 类 号：R541.6[医药卫生—心血管疾病]