沙库巴曲缬沙坦钠对射血分数减低的心力衰竭合并高血压患者血压及相关指标变化的研究  

Change of BP and related indexes in HFrEF patients with hypertension after sacubitril valsartan treatment

作　　者：赖朝辉 刘迎午[1] 王禹[1] 彭文近[1] 李鑫[1] 王赟赟[1] 吴鹏[1] 刘博江[1] Lai Chaohui;Liu Yingwu;Wang Yu;Peng Wenjin;Li Xin;Wang Yunyun;Wu Peng;Liu Bojiang(Cardiology Center,Tianjin Third Central Hospital,Tianjin 300170,China)

机构地区：[1]天津市第三中心医院心脏中心,天津市肝胆疾病研究所,天津市人工细胞重点实验室卫生部人工细胞工程技术研究中心,300170

出　　处：《中华老年心脑血管病杂志》2022年第1期11-13,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的研究射血分数减低的心力衰竭(HFrEF)合并高血压患者经沙库巴曲缬沙坦钠治疗后血压及心力衰竭(心衰)指标的变化及不良反应。方法选择HFrEF患者116例,按照随机数表法分为观察组58例,对照组58例,对照组给予血管紧张素转换酶抑制剂(ACEI)/血管紧张素受体阻滞剂(ARB)和β受体阻滞剂以及醛固酮受体拮抗剂等相关药物。试验时停用ACEI或ARB,其余用药方案不变。观察组在此基础上予沙库巴曲缬沙坦钠,2组均治疗6个月。对比2组血压、心衰指标以及不良反应。结果2组治疗后LVEF较治疗前明显升高,收缩压、舒张压、左心室舒张末期内径(LVEDD)和左心室收缩末期内径(LVESD)较治疗前明显降低,且观察组LVEF较对照组明显升高[(52.49±5.11)%vs(43.46±5.24)%,P=0.000],收缩压、舒张压、LVEDD和LVESD较对照组明显降低(P<0.05,P<0.01)。观察组不良反应总发生率高于对照组,但差异无统计学意义(5.2%vs 3.4%,P>0.05)。结论HFrEF合并高血压患者沙库巴曲缬沙坦钠治疗效果较好,能够有效改善血压及心衰指标,且安全性较好。Objective To study the changes of BP,HF and adverse reactions in HFrEF and hyper-tension after sacubitril valsartan treatment.Methods One hundred and sixteen HFrEF patients admitted to our hospital from November 2019 to November 2020 were randomly divided into ob-servation group(n=58)and control group(n=58).The patients in control group were treated with ACEI/ARB,βreceptor blockers and aldosterone receptor antagonists for 6 months,the ACEI or ARB was withdrawn with the other medications unchanged during the experiment.Those in observation group received the same treatment of control group in addition to sacubitril valsartan for 6 months.The BP and HF indexes and adverse reactions were compared between the two groups.Results The LVEF was significantly higher(52.49%±5.11%vs 43.46%±5.24%,P=0.000),the SBP and DBP were significantly lower,and the LVEDD and LVESD were significantly shorter in two groups after treatment than before treatment and in observation group than in con-trol group(P<0.05,P<0.01).Although the total incidence of adverse reactions was higher in observation group than in control group,no significant difference was detected between the two groups(5.2%vs 3.4%,P>0.05).Conclusion The therapeutic effect of sacubitril valsartan is rather good for HFrEF patients.Sacubitril valsartan can effectively improve their BP and HF in-dexes with a high safety,and is thus worthy of popularization.

关 键 词：心力衰竭 高血压 血管紧张素转换酶抑制药 血管紧张素受体拮抗剂 

分 类 号：R541.6[医药卫生—心血管疾病] R544.1[医药卫生—内科学]