沙库巴曲缬沙坦对老年1型心肾综合征患者的临床疗效  

Clinical efficacy of sacubitril-valsartan on elderly patients with type 1 cardiorenal syndrome

作　　者：赵红亮 赵秀杰[2] 张慧杰[2] 魏立业 戚国庆[2] 贾玮玲[2] 崔炜 ZHAO Hong-liang;ZHAO Xiu-jie;ZHANG Hui-jie;WEI Li-ye;QI Guo-qing;JIA Wei-ling;CUI Wei(Department of Cardiology,the Second Hospital of Hebei Medical University,Hebei Shijiazhuang 050000,China;Department of Cardiology,the First Hospital of Hebei Medical University,Hebei Shijiazhuang 050031,China)

机构地区：[1]河北医科大学第二医院心内科,河北石家庄050000 [2]河北医科大学第一医院心内科,河北石家庄050031

出　　处：《中国医院药学杂志》2021年第11期1127-1130,1136,共5页Chinese Journal of Hospital Pharmacy

摘　　要：目的:观察沙库巴曲缬沙坦对老年1型心肾综合征(CRS-1)患者的临床疗效。方法:选取某院2017年9月-2020年9月收治的老年急性失代偿性心力衰竭(ADHF)引起的急性肾损伤(AKI)患者,即CRS-1患者98例为研究对象,随机分为对照组和治疗组各49例。治疗组在常规治疗的同时应用沙库巴曲缬沙坦钠片(ARNI),对照组则在常规用药的同时应用血管紧张素抑制剂/血管紧张素受体抑制剂(ACEI/ARB),2组均治疗4周。比较2组治疗后ADHF的疗效,对比治疗前后血肌酐(SCr)、N端前脑钠肽(NT-proBNP)、超敏C反应蛋白(hs-CRP)、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)及6分钟步行试验距离(6MWTD)变化,并观察不良反应发生情况。结果:治疗前2组SCr、NT-proBNP、hs-CRP、LVEF、LVEDD及6MWTD水平比较无统计学差异(P>0.05),治疗后2组SCr、NT-proBNP、hs-CRP、LVEDD及水平均有所下降(P<0.05),LVEF和6MWTD水平均较前升高(P<0.05),组间比较存在差异(P<0.05)。治疗组和对照组ADHF改善总有效率分别为91.8%和77.5%,2组比较有统计学差异(P=0.049)。2组不良反应发生率相当(P=0.564)。结论:沙库巴曲缬沙坦对老年CRS-1疗效显著,可明显改善患者心、肾功能,且安全性较高,值得临床推广应用。OBJECTIVE To observe the clinical efficacy of sacubitril-valsartan on elderly patients with type 1 cardiorenal syndrome(CRS-1).METHODS From September 2017 to September 2020,98 patients with acute kidney injury(AKI)due to acute decompensated heart failure(ADHF),also known as type 1 cardiorenal syndrome(CRS-1),were selected as study subjects.They were randomly divided into control and treatment groups(n=49 each).Both groups received general medications for ADHF.In addition,treatment group had sacubitril-valsartan tablets(ARNI)while control group angiotensin converting enzyme inhibitors/angiotensin receptor inhibitors(ACEI/ARB).After 4-week treatment,the levels of serum creatinine(Scr)N-terminal pro-brain peptide(NT-proBNP),hypersensitive C-reactive protein(hs-CRP),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)and six-minute walk test distance(6 MWTD)were compared between 2 groups.Also the therapeutic efficacy of ADHF and adverse reactions were observed.RESULTS The pre-treatment levels of SCr,NT-proBNP,hs-CRP,LVEF,LVEDD and 6 MWTD showed no statistical inter-group difference(P>0.05).And the post-treatment levels of SCr,NT-proBNP,hs-CRP and LVEDD declined(P<0.05)while the levels of LVEF and 6 MWTD increased in both groups.And there were inter-group differences(P<0.05).The overall effective rate of ADHF was 91.8%and 77.5%in treatment and control groups respectively.Treatment group was significantly better than control group(P=0.049).The incidence of adverse reactions showed no inter-group differences(P=0.564).CONCLUSION Shakuba-trivalsartan is both safe and efficacious for elderly patients with CRS-1.It can significantly improve cardiorenal functions and wider popularization is worthy.

关 键 词：沙库巴曲缬沙坦 心肾综合征 1型 急性失代偿性心力衰竭 老年患者 临床疗效 

分 类 号：R541.4[医药卫生—心血管疾病]