沙库巴曲缬沙坦治疗冠心病并慢性心力衰竭的临床观察  

The Clinical Observation of Sacubitril Valsartan on Treatment of Coronary Heart Disease with Chronic Heart Failure

作　　者：尹承华 刘英[2] 贾治生[1] YIN Chenghua;LIU Ying;JIA Zhisheng(The Fifth People’s Hospital of Ji’nan,Ji’nan 250001,China;不详)

机构地区：[1]济南市第五人民医院,山东济南250001 [2]山东省荣军总医院

出　　处：《中国医学创新》2020年第32期10-14,共5页Medical Innovation of China

摘　　要：目的:观察沙库巴曲缬沙坦治疗冠心病并慢性心力衰竭的临床效果。方法:选取2019年1-9月本院收治的92例冠心病并慢性心力衰竭的患者为研究对象,按照入院顺序及患者的性别、年龄、病程及合并症等组间均衡的原则分为ARNI组(45例)和ACEI/ARB组(47例)。所有患者在常规治疗心力衰竭药物的基础上,ARNI组给予沙库巴曲缬沙坦治疗,ACEI/ARB组给予盐酸贝那普利或缬沙坦治疗。比较两组临床效果以及6分钟步行试验(6MWT)距离、N末端脑钠肽前体(NT-proBNP)水平、LVEF的变化情况。结果:出院后3个月,ARNI组的临床总有效率高于ACRI/ARB组,差异有统计学意义(P<0.05)。出院后3个月,两组6MWT、LVEF均较治疗前提高,NT-proBNP均较治疗前下降,且ARNI组6MWT、LVEF均优于ACEI/ARB组,NT-proBNP低于对照组,差异均有统计学意义(P<0.01)。结论:与盐酸贝那普利/缬沙坦比较,沙库巴曲缬沙坦治疗冠心病并慢性心力衰竭效果显著,可明显改善患者心功能,提高活动耐量,临床可推广应用。Objective:To observe the clinical effect of Sacubitril Valsartan in the treatment of coronary heart disease with chronic heart failure.Method:From January to September 2019,a total of 92 patients who suffered from the coronary heart disease with chronic heart failure were selected as the study objects.According to the principle of admission order,gender,age,course of disease and complication,they were divided into the ARNI group (45 cases) and the ACEI/ARB group (47 cases).On the basis of conventional application of drugs for heart failure,patients in the ARNI group was treated with Sacubitril Valsartan,while those in the ACEI/ARB group treated with Benazepril Hydrochloride or Valsartan.All patients were followed up for three months.Clinical efficiency,6-minute walk test (6MWT) distance,N-terminal pro-brain natriuretic peptid (NT-proBNP) and left ventricular ejection fraction (LVEF) before and after treatment were compared between the two groups.Result:3 months after discharge from hospital,the total clinical response rate of ARNI group was higher than that of ACRI/ARB group,with statistically significant difference (P<0.05).3 months after discharge from hospital,both groups of 6MWT and LVEF were increased compared with before treatment,and NT-proBNP were decreased compared with before treatment,and 6MWT and LVEF in ARNI group were better than those of the ACEI/ARB group,and NT-proBNP was lower than that of the control group,the differences were statistically significant (P<0.01).Conclusion:Compared with Benazepril Hydrochloride or Valsartan,Sacubitril Valsartan has a significant effect in the treatment of coronary heart disease with chronic heart failure,which can significantly improve cardiac function and activity tolerance in patients,and can be widely applied in clinical practice.

关 键 词：慢性心力衰竭 沙库巴曲缬沙坦 缬沙坦 贝那普利 

分 类 号：R541.6[医药卫生—心血管疾病] R541.4[医药卫生—内科学]