沙库巴曲缬沙坦治疗射血分数保留心功能衰竭的效果研究  

Effect of sakubatril valsartan on heart failure with preserved ejection fraction

作　　者：曹祯 丁爱梅 王向明[1] 贾恩志[1] 陈波[1] 陶正贤[1] Cao Zhen;Ding Aimei;Wang Xiangming;Jia Enzhi;Chen Bo;Tao Zhengxian(First Affiliated Hospital of Nanjing Medical University,Nanjing 210000,China;不详)

机构地区：[1]南京医科大学第一附属医院,南京210000 [2]南京医科大学,南京210000

出　　处：《中国循证心血管医学杂志》2022年第8期967-970,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：江苏省六大人才高峰基金资助项目(2015-WSN-032)。

摘　　要：目的分析沙库巴曲缬沙坦在射血分数保留心功能衰竭(HFpEF)患者救治过程中的效果以及安全性。方法前瞻性选择2017年1月至2020年10月于南京医科大学心血管内科收治入院的HFpEF患者93例作为研究对象。依据随机数字表法将患者分为对照组(47例)和观察组(46例)两组。患者入院后均给予常规治疗,对照组在常规治疗基础上给予盐酸贝那普利,观察组在常规治疗基础上给予沙库巴曲缬沙坦。对比两组患者的心脏超声指标、血清N末端脑钠肽前体(NT-proBNP)水平、6 min步行试验(6MWT)、血压、心率、NYHA分级、药物不良反应情况及随访期内的心血管不良事件之间的差异。结果治疗前与治疗后,两组的左心室射血分数(LVEF),左心室舒张末期内径(LVEDD)未发生明显变化(P均>0.05)。治疗前两组的NT-proBNP、6MWT、收缩压、舒张压、心率对比,差异无统计学意义(P均>0.05)。治疗后两组的NT-proBNP、6MWT、收缩压、舒张压、心率均改善,差异有统计学意义(P均<0.05)。出院后3个月,观察组的NYHA分级低于对照组(P<0.05)。两组的药物不良反应比较,差异无统计学意义(P>0.05)。随访期内,观察组的心血管不良事件发生率低于对照组(P<0.05)。结论对于HFpEF患者,常规治疗基础上使用沙库巴曲缬沙坦,有助于提升疗效,改善心功能指标,预防出院后短期内的各项不良心血管事件,药物安全性良好。Objective To analyze the efficacy and safety of sakubatril-valsartan in the treatment of patients with heart failure with preserved ejection fraction(HFpEF).Methods HFpEF patients(n=93)were chosen from Department of Cardiovascular Medicine in the First Affiliated Hospital of Nanjing Medical University from Jan.2017 to Oct.2020.All patients were divided,according to random digital table,into control group(n=47)and observation group(n=46).The control group was treated with routine therapy and benazepril hydrochloride and observation group was treated with routine therapy and sakubatril-valsartan.The indexes of cardiac ultrasound,level of N-terminal pro-brain natriuretic peptide(NT-proBNP),6-minute walk test(6MWT),blood pressure(BP),heart rate(HR),NYHA classification,adverse drug reactions(ADR),and adverse cardiovascular events during follow-up period were compared between 2 groups.Results The levels of left ventricular ejection fraction(LVEF)and left ventricular end diastolic diameter(LVEDD)had no significant changes in 2 groups before and after treatment(all P>0.05).The differences in NT-proBNP,6MWT,systolic blood pressure(SBP),diastolic blood pressure(DBP)and HR had no statistical significance between 2 groups before treatment(all P>0.05).After treatment,NT-proBNP,6MWT,SBP,DBP and HR were all improved in 2 groups(all P<0.05).The grade of NYHA classification was lower in observation group than that in control group after discharged for 3 months(P<0.05).The difference in ADR had no statistical significance between 2 groups(P>0.05).During follow-up period,the incidence rates of adverse cardiovascular events were lower in observation group than those in control group(P<0.05).Conclusion For HFpEF patients,the administration of sakubatril-valsartan based on routine therapy can help promote therapeutic efficacy,improve heart function indicators,and prevent patients from various adverse cardiovascular events in a short term after discharged with a higher safety.

关 键 词：沙库巴曲缬沙坦 射血分数保留心功能衰竭 终末期 心功能 

分 类 号：R541.61[医药卫生—心血管疾病]