射血分数下降的心力衰竭患者常规剂量沙库巴曲缬沙坦与靶剂量ACEI疗效对比:真实世界队列研究  

Treatment comparison between actual dose of sacubitril⁃valsartan and target dose of ACEI in patients with heart failure with reduced ejection fraction:a real⁃world cohort study

作　　者：戴聪 胡龙龙 邹凯 阮月华 杨慧 黎雨民 郭方君 叶赛 陈洋 唐良 吴延庆[1] 吴清华[1] 程晓曙[1] 杨人强[1] DAI Cong;HU Longlong;ZOU Kai;RUAN Yuehua;YANG Hui;LI Yumin;GUO Fangjun;YE Sai;CHEN Yang;TANG Liang;WU Yanqing;WU Qinghua;CHENG Xiaoshu;YANG Renqiang(Department of Cardiovascular Diseases,the Second Affiliated Hos-pital,Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第二附属医院心血管科,南昌330006

出　　处：《实用医学杂志》2020年第22期3084-3087,3093,共5页The Journal of Practical Medicine

基　　金：国家自然科学基金项目(编号:81960081,81660063)。

摘　　要：目的比较常规剂量的沙库巴曲缬沙坦(诺欣妥)与靶剂量ACEI对射血分数下降的心力衰竭(HFrEF)患者的治疗效果。方法连续性纳入我院223例诊断为扩张型心肌病心力衰竭患者,111例给予诺欣妥治疗(观察组),112例给予ACEI标准治疗(对照组),其他治疗遵循指南要求。随访连续治疗18个月。结果观察组平均使用剂量为138.96 mg/d,1.8%患者达到靶剂量。对照组47.3%患者达到靶剂量。观察组的临床有效率、6 min步行试验及收缩压下降幅度均高于对照组,且BNP及MLHFQ评分、再入院时间及次数均低于对照组(P<0.05)。结论在我院真实世界治疗HFrEF患者中,只是极少数患者使用诺欣妥达到靶剂量;但相比靶剂量的ACEI,常用剂量的诺欣妥在抑制心室重构方面不逊色于靶剂量ACEI,且改善生活质量更加明显。Objective To compare the therapeutic effects of conventional dose of sacubitril⁃valsartan(ARNI)and target dose of ACEI in patients with heart failure with reduced ejection fraction(HFrEF).Methods Totally 223 patients with heart failure diagnosed as dilated cardiomyopathy were continuously included in our hospital,of which 111 patients were treated with ARNI(experimental group)and 112 with ACEI standard treatment(control group),in addition to the treatments followed the guidelines.Follow⁃up treatment for 18 months was conducted.Results The average dose of ARNI was 138.96 mg,and 1.8%of the patients achieved target dose.The target dose reached in 47.3%of the patients in the control group.The clinical efficiency,6⁃minute walking test and SBP decrease in the experimental group were all higher than those in the control group,and BNP and MLHFQ scores,readmitted time and times were all lower than those in the control group(P<0.05).Conclusions In the real world treatment of HFrEF patients in our hospital,a very small number of patients achieve the target dose of ARNI.However,the effect of frequently⁃used dose of ARNI is not inferior to that of target dose of ACEI in terms of inhibiting ventricular remodeling,while the improvement of quality of life is even obvious.

关 键 词：沙库巴曲缬沙坦 心力衰竭 ACEI 队列研究 

分 类 号：R541.61[医药卫生—心血管疾病] R542.2[医药卫生—内科学]