沙库巴曲缬沙坦在扩张型心肌病患者中的疗效观察  

Clinical Effects of Sacubitril Valsartan in Dilated Cardiomyopathy Patients

作　　者：翟莉[1] 吕俊刚[1] 张琳[1] 李明[1] 王娜 王松涛 ZHAI Li;LV Jun-gang;ZHANG Lin;LI Ming;WANG Na;WANG Song-tao(Beijing Armed Police Corps Hospital of the Chinese People's Armed Police Force,The Third Department of Internal Medicine,Beijing 100027 China;Beijing Armed Police Corps Hospital of the Chinese People's Armed Police Force,President Office,Beijing 100027 China)

机构地区：[1]中国人民武装警察部队北京市总队医院内三科,北京市100027 [2]中国人民武装警察部队北京市总队医院院长办公室,北京市100027

出　　处：《中国分子心脏病学杂志》2020年第6期3602-3605,共4页Molecular Cardiology of China

摘　　要：目的观察沙库巴曲缬沙坦在扩张型心肌病患者慢性心力衰竭的疗效及安全性。方法选择扩张型心肌病患者102例,随机分为厄贝沙坦组和试验组,试验组患者在一般治疗方案基础上口服沙库巴曲缬沙坦,厄贝沙坦组患者在一般治疗方案基础上口服厄贝沙坦。分别在入院治疗后3、6及12个月进行随访观察,同时根据超声心动图及实验室检查结果,判断患者的预后情况及药物的安全性。结果两组患者心衰症状改善明显,厄贝沙坦组患者N末端B型脑利钠肽(NT-proBNP)治疗后较前降低[(3332.33±534.53)ng vs(12225.27±2647.92)ng,P<0.05],LVEF、左心室舒张末容积(LVEDV)较治疗前好转,但均无统计学意义(P>0.05)。在观察6个月、12个月试验组NTproBNP、LVEDV、LVEF较治疗前均有改善(P<0.05),且试验组优于厄贝沙坦组:分别为[(3055.55±689.13)ng/L、(1981.53±476.17)ng/L vs(4178.43±712.66)ng/L、(3332.33±534.53)ng/L、(61.06±4.24)mm、(58.96±3.52)mm vs(61.55±5.07)mm、(59.10±4.27)mm、(39.14±2.54)%、(44.45±2.72)%vs(35.92%±2.68)%、(39.98±1.97)%],有显著差异(P<0.05);沙库巴曲缬沙坦治疗未见明显不良反应。结论新型治疗心力衰竭的药物沙库巴曲缬沙坦可提高扩张型心肌病患者的疗效,心功能及心脏结构得到改善。Objective To observe the effect and safety of sacubitril valsartan in the treatment of chronic heart failure in patients with dilated cardiomyopathy.Methods 102 patients with dilated cardiomyopathy induced chronic heart failure were selected and randomly divided into irbesartan group and experimental group.Patients in treatment group were orally taken with sacubitril valsartan on the basis of general treatment scheme,while patients in control group were orally taken with irbesartan on the basis of general treatment scheme.Follow-up observation was carried out at 3 months,6 months and 12 months after admission.Meanwhile,According to the results echocardiography and laboratory examination,the prognosis and safety of the drug were evaluated.Results The patient’s symptoms improved significantly.In the irbesartan group,NT-probnp level was decreased after treatment as compared with before treatment[(3332.33±534.53)ng vs(12225.27±2647.92)ng,P<0.05],and no significant difference was found in LVEF and LVEDV at post-treatment versus pretreatment(P>0.05).In the experimental group NT-ProBNP,LVEF and LVEDV were significantly improved in post-treatment versus pre-treatment,with significant difference(P<0.05);And in the observation of 6 months and 12 months,NT-proBNP,LVEF and LVEDV were significantly better in the experimental group than in the irbesartan group[(3055.55±689.13)ng/L and(1981.53±476.17)ng/Lvs(4178.43±712.66)ng/L and(3332.33±534.53)ng/L,(61.06±4.24)mm and(58.96±3.52)mm vs(61.55±5.07)mm and(59.10±4.27)mm,(39.14±2.54)%and(44.45±2.72)%vs(35.92%±2.68)%and(39.98±1.97)%],there were significant difference(P<0.05);there was no obvious adverse reaction in the treatment group.Conclusion The new drug for the treatment of heart failure,sacubitril valsartan can effectively improve the curative effect of patients with dilated cardiomyopathy,significantly improve cardiac function and cardiac structure.

关 键 词：沙库巴曲缬沙坦 扩张型心肌病 慢性心力衰竭 

分 类 号：R542.2[医药卫生—心血管疾病]