沙库巴曲缬沙坦钠联合环磷腺苷葡胺治疗舒张性心力衰竭的临床研究  

Clinical study on sacubitril valsartan sodium combined with meglumine adenosine cyclophosphate in treatment of diastolic heart failure

作　　者：戴颐 DAI Yi(Department of Cardiology,Tianjin Chest Hospital,Tianjin 300222,China)

机构地区：[1]天津市胸科医院心功能科,天津300222

出　　处：《现代药物与临床》2020年第11期2233-2237,共5页Drugs & Clinic

摘　　要：目的探讨沙库巴曲缬沙坦钠联合环磷腺苷葡胺治疗舒张性心力衰竭的临床疗效。方法选取2017年3月—2019年3年在天津市胸科医院治疗的舒张性心力衰竭患者136例,随机分为对照组(68例)和治疗组(68例)。对照组患者静脉滴注环磷腺苷葡胺注射液,90 mg加入5%葡萄糖500 mL,1次/d;治疗组在对照组基础上口服沙库巴曲缬沙坦钠片,起始剂量50 mg/次,2次/d,逐步增加每天用药达到400 mg,连续服药15 d。观察两组患者临床疗效,同时比较治疗前后两组患者心功能指标左心室射血分数(LVEF)、左心室收缩末内径(LVESD)、左心室舒张末期内径(LVEDD)和左心室收缩末期容积(LVESV),6 min步行距离,明尼苏达心力衰竭生活质量量表(MLHFQ)评分,及血清脑钠肽(BNP)、超敏C反应蛋白(hs-CRP)、醛固酮(ALD)和白细胞介素-6(1L-6)水平。结果治疗后,对照组和治疗组临床总有效率分别为73.53%、95.59%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组LVEF指标显著升高(P<0.05),LVESD、LVEDD和LVESV指标显著降低(P<0.05),且治疗组这些心功能指标明显好于对照组(P<0.05)。治疗后,两组患者6 min步行距离显著增加(P<0.05),MLHFQ评分明显下降(P<0.05),且治疗组患者明显好于对照组(P<0.05)。治疗后,两组患者血清BNP、1L-6、hs-CRP和ALD水平明显降低(P<0.05),且治疗组患者明显低于对照组(P<0.05)。结论环磷腺苷葡胺联合沙库巴曲缬沙坦钠治疗舒张性心力衰竭,可改善患者心功能,提高患者运动耐量,具有一定的临床推广应用价值。Objective To explore the clinical efficacy of sacubitril valsartan sodium combined with meglumine adenosine cyclophosphate in treatment of diastolic heart failure.Methods Patients(136 cases)with diastolic heart failure in Tianjin Chest Hospital from March 2017 to March 2019 were randomly divided into control(68 cases)and treatment(68 cases)groups.Patients in the control group were iv administered with Meglumine Adenosine Cyclophosphate Injection,90 mg added into 5%Glucose Injection 500 mL,once daily.Patients in the treatment group were po administered with Sacubitril Valsartan Sodium Tablets on the basis of the control group,and the initial dosage was 50 mg/time,twice daily,then gradually increase to 400 mg/d.Patients in two groups were treated for 15 d.After treatment,the clinical efficacy was evaluated,and the cardiac function indexes of LVEF,LVESD,LVEDD,and LVESV,6 min walking distance,MLHFQ score,and the serum levels of BNP,IL-6,hs-CRP and ALD in two groups before and after treatment were compared.Results After treatment,the clinical efficacy and in the control and treatment groups was 73.53%and 95.59%,respectively,and there were differences between two groups(P<0.05).After treatment,the LVEF in two groups was significantly increased(P<0.05),but the LVESD,LVEDD and LVESV levels in two groups were significantly decreased(P<0.05),and the cardiac function indexes in the treatment group were significantly better than those in the control group(P<0.05).After treatment,6 min walking distance in two groups was significantly increased(P<0.05),but MLHFQ score in two groups were significantly decreased(P<0.05),and the indexes in the treatment group were significantly better than those in the control group(P<0.05).After treatment,the serum levels of BNP,IL-6,hs-CRP and ALD in two groups were significantly decreased(P<0.05),and which in the treatment group were significantly lower than those in the control group(P<0.05).Conclusion Sacubitril valsartan sodium combined with meglumine adenosine cyclophosphate in treatment o

关 键 词：沙库巴曲缬沙坦钠片 环磷腺苷葡胺注射液 舒张性心力衰竭 6 min步行试验 左心室射血分数 脑钠肽 

分 类 号：R972[医药卫生—药品]