沙库巴曲-缬沙坦治疗老年充血性心力衰竭患者的疗效  

Therapeutic effect of sacubitril-valsartan on aged patients with congestire heart failure

作　　者：李喆[1] 常凤军[1] 李文波[1] LI Zhe;CHANG Feng-jun;LI Wen-bo(Third Department of Cardiology,People's Hospital of Shaanxi Provinciale,Xi'an,Shaanxi,710068,China)

机构地区：[1]陕西省人民医院心血管内科,陕西西安710068

出　　处：《心血管康复医学杂志》2021年第5期548-552,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:研究沙库巴曲-缬沙坦治疗老年充血性心力衰竭(CHF)患者的临床疗效及安全性。方法:于我院治疗的90例老年CHF患者被随机均分为缬沙坦组(在常规治疗基础上加用缬沙坦)和血管紧张素受体脑啡肽酶抑制剂(ARNI)组(在常规治疗基础上加用沙库巴曲-缬沙坦),两组均治疗6个月。观察比较两组治疗前后LVEF、左室舒张末期内径(LVEDd)、血浆N基末端脑钠肽前体(NT-proBNP)水平、血清丙氨酸转氨酶(ALT)、白蛋白(Alb)、肌酐(Cr)、钾离子血钾(K+)水平及,治疗总有效率和不良反应发生率。结果:与缬沙坦组比较,治疗后ARNI组LVEF[(39.24±3.11)%比(41.60±4.22)%]升高更显著,LVEDd[(61.29±4.98)mm比(56.71±6.16)mm]、血浆NT-proBNP水平[(2950.14±610.11)pg/ml比(2257.65±426.53)pg/ml]降低更显著,P均<0.01。两组治疗前后血清ALT、Alb、Cr、K+水平均无显著差异,P均>0.05。治疗6个月后,ARNI组治疗总有效率显著高于缬沙坦组(93.33%比73.33%,P=0.011),两组不良反应发生率无显著差异(P=0.673)。结论:沙库巴曲-缬沙坦可显著改善老年CHF患者心功能,疗效显著,安全性好。Objective:To study therapeutic effect of sacubitril-valsartan on aged patients with chronic heart failure(CHF)and its safety.Methods:A total of 90 aged CHF patients treated in our hospital were randomly and equally divided into valsartan group(received valsartan based on routine treatment group)and angiotensin receptor neprilysin inhibitor(ARNI)group(received sacubitril-valsartan based on routine treatment).Both groups were treated for six months.LVEF,left ventricular end-diastolic dimension(LVEDd),levels of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP),serum alanine transaminase(ALT),albumin(Alb),creatinine(Cr)and potassium ion(K+)before and after treatment,and total effective rate and incidence rate of adverse reaction were observed and compared between two groups.Results:Compared with valsartan group,after treatment,there was significant rise in LVEF[(39.24±3.11)%vs.(41.60±4.22)%],and significant reductions in LVEDd[(61.29±4.98)mm vs.(56.71±6.16)mm]and plasma NT-proBNP level[(2950.14±610.11)pg/ml vs.(2257.65±426.53)pg/ml]in ARNI group,P<0.01 all.There were no significant difference in serum levels of ALT,Alb,Cr,K+between two group before and after treatment,P<0.05 all.After six-months treatment,total effective rate of ARNI group was significantly higher than that of valsartan group(93.33%vs.73.33%,P=0.011),and there was no significant difference in incidence rate of adverse reaction between two groups(P=0.673).Conclusion:Sacubitril-valsartan can significantly improve cardiac function with significant therapeutic effect and good safety in aged CHF patients.

关 键 词：心力衰竭 脑啡肽酶 丙氨酸转氨酶 

分 类 号：R541.6[医药卫生—心血管疾病]