沙库巴曲缬沙坦对慢性心力衰竭患者的抗室性心律失常作用  

Anti-ventricular arrhythmia effect of sacubitril/valsartan on patients with chronic heart failure

作　　者：裴强 王强 羊镇宇 陈茂华 王如兴 PEI Qiang;WANG Qiang;YANG Zhenyu;CHEN Maohua;WANG Ruxing(Department of Cardiovascular Medicine,Wuxi People's Hospital Affiliated to Nanjing Medical University,Wuxi Jiangsu 214023,China)

机构地区：[1]南京医科大学附属无锡人民医院心血管内科,江苏无锡214023

出　　处：《实用心电学杂志》2021年第5期342-345,共4页Journal of Practical Electrocardiology

摘　　要：目的探讨沙库巴曲缬沙坦(LCZ696)对慢性心力衰竭患者的抗室性心律失常作用。方法选取116例射血分数降低的心力衰竭患者作为研究对象,就LCZ696服用前和服用后6个月的心电图和动态心电图结果进行对比分析。结果服用LCZ696的心力衰竭患者治疗前和治疗后6个月β受体阻滞剂、螺内酯、地高辛、胺碘酮等药物的使用率比较,差异无统计学意义(P>0.05)。与治疗前相比,治疗后患者心电图QRS波时限[(124.8±35.2)ms vs.(120.7±32.7)ms]及S_(V_(1))+R_(V_(5))[(20.9±11.3)mm vs.(17.1±9.3)mm]均明显降低(P<0.05),QTc[(461.6±40.2)ms vs.(448.5±39.5)ms]及QT离散度[(78.2±10.6)ms vs.(51.2±8.6)ms]均显著降低(P<0.01)。治疗后持续性室速发作的患者由8例减少至3例(P<0.05),持续性室速总发作次数由19次降至5次(P<0.01)。非持续性室速发作的患者由61例减少至49例(P<0.01),人均非持续性室速发作次数由(7.2±9.8)次降至(3.5±4.9)次(P<0.01)。每小时室性早搏发作次数由(35.0±6.2)次降至(9.0±3.5)次(P<0.01)。结论服用LCZ696的心力衰竭患者室性心律失常的发生有所减少,心电图的QRS波时限、QTc、QT离散度显著降低。Objective To explore the anti-ventricular arrhythmia effect of sacubitril/valsartan(LCZ696)on patients with chronic heart failure.Methods We selected 116 heart failure patients with reduced ejection fraction(HFrEF)as the research subjects.Electrocardiogram(ECG)and ambulatory electrocardiography(AECG)results were made comparative analysis before taking LCZ696 and 6 months after treatment.Results The utilization rate of drugs including beta-blockers,spironolactone,digoxin and amiodarone does not vary significantly before taking LCZ696 and 6 months after treatment(P>0.05).Compared with those before treatment,QRS duration[(124.8±35.2)ms vs.(120.7±32.7)ms]and S_(V_(1))+R_(V_(5))[(20.9±11.3)mm vs.(17.1±9.3)mm]after treatment both significantly decrease(P<0.05);corrected QT interval(QTc)[(461.6±40.2)ms vs.(448.5±39.5)ms]and QT dispersion(QTd)[(78.2±10.6)ms vs.(51.2±8.6)ms]after treatment both significantly decrease(P<0.01).The number of patients attacked by sustained ventricular tachycardia after treatment decreases from 8 to 3(P<0.05);the total number of SVT attacks decreases from 19 to 5(P<0.01).The number of cases attacked by non-sustained ventricular tachycardia(NSVT)decreases from 61 to 49(P<0.01);the number of attacks of NSVT per person decreases from(7.2±9.8)to(3.5±4.9)(P<0.01);the number of attacks of premature ventricular contraction per hour is reduced from(35.0±6.2)times to(9.0±3.5)times(P<0.01).Conclusion LCZ696 therapy is associated with decreased risk of ventricular arrhythmia,and significantly reduced QRS duration,QTc and QTd among patients with heart failure.

关 键 词：沙库巴曲缬沙坦 室性心律失常 心力衰竭 心脏性猝死 射血分数 

分 类 号：R541.7[医药卫生—心血管疾病]