沙库巴曲缬沙坦联合海昆肾喜治疗慢性左心衰竭合并肾功能不全的临床疗效观察  

Observation of the clinical efficacy of sacubitril-valsartan combined with Haikun Shenxi in the treatment of chronic left heart failure with renal insufficiency

作　　者：袁义丽[1] Yuan Yili(Department of Cardiovascular Medicine,Dalian Municipal Central Hospital,Dalian 116033,China)

机构地区：[1]大连市中心医院心血管内科,大连116033

出　　处：《中国医师进修杂志》2022年第9期847-852,共6页Chinese Journal of Postgraduates of Medicine

摘　　要：目的观察沙库巴曲缬沙坦联合海昆肾喜治疗慢性左心衰竭合并肾功能不全的临床疗效。方法选取大连市中心医院2019年10月至2020年10月收治的慢性左心衰竭合并肾功能不全患者80例作为研究对象,按照随机数字表法分成对照组和观察组各40例,对照组采取沙库巴曲缬沙坦治疗,观察组基于对照组加用海昆肾喜胶囊,比较两组N-末端脑钠肽前体(NT-proBNP)、心功能指标、肾功能指标、血气指标以及生命质量。结果观察组治疗后NT-proBNP、血清肌酐(Scr)、尿素氮(BUN)明显低于对照组[(1 034.27 ± 87.33) μg/L比(1 421.46 ± 105.54) μg/L、(240.53 ± 45.26) μmol/L比(284.52 ± 52.47) μmol/L、(12.05 ± 1.87) mmol/L比(15.79 ± 1.87) mmol/L],差异有统计学意义(t = 17.88、4.01、8.62,P<0.01);观察组治疗后左心室舒张末期内径(LVEDD)低于对照组[(46.12 ± 1.05) mm比(48.81 ± 1.74) mm]、左心室射血分数(LVEF)、心脏指数(CI)均明显高于对照组[(49.95 ± 2.17)%比(45.24 ± 3.22 )%、(2.98 ± 0.55) L/(min·m2)比(2.45 ± 0.73) L/(min·m2)],差异均有统计学意义(t = 7.67、8.38、3.66,P<0.01);观察组治疗后血气指标动脉血二氧化碳分压(PaCO_(2))低于对照组[(46.34 ± 3.52) mmHg(1 mmHg = 0.133 kPa)比(51.63 ± 4.25) mmHg],动脉血氧分压(PaO_(2))、动脉血氧饱和度(SO_(2))、pH值、HCO3-、碱剩余(BE)均高于对照组[(69.35 ± 5.12) mmHg比(62.45 ± 4.86) mmHg、(90.46 ± 4.02)%比(85.36 ± 4.32)%、7.32 ± 0.12比7.22 ± 0.15、(23.1 ± 2.0) mmol/L比(21.5 ± 1.9) mmol/L、(-1.57 ± 0.67) mmol/L比(-2.15 ± 0.85) mmol/L],差异均有统计学意义(t = 6.06、6.18、5.47、3.33、3.67、3.39,P<0.01);观察组治疗后生命质量各项评分躯体领域(PD)、情绪领域(ED)、其他领域(OD)、总分(TS)均低于对照组[(17.80 ± 3.11)分比(22.35 ± 2.72)分、(12.28 ± 2.10)分比(15.74 ± 1.73)分、(18.27 ± 1.69)分比(25.54 ± 2.33)分、(46.68 ± 3.15)分比(62.17 ± 3.63)分],差异均有统计学意义(t = 6.97Objective To observe the clinical efficacy of sacubitril-valsartan combined with Haikun Shenxi in the treatment of chronic left heart failure with renal insufficiency.Methods A total of 80 patients with chronic left heart failure and renal insufficiency who were admitted to Dalian Municipal Central Hospital from October 2019 to October 2020 were selected as the research objects.They were divided into two groups by random digits table method,40 cases in each group.The control group was treated with sacubitril-valsartan.The observation group was based on the control group plus Haikun Shenxi Capsule,and N-terminal pro-brain natriuretic peptide(NT-proBNP),heart function indexes,kidney function indexes,blood gas indexes and quality of life in two groups were compared.Results NT-proBNP,serum creatinine and blood urea nitrogen in the observation group were significantly lower than those in the control group after treatment:(1034.27±87.33)μg/L vs.(1421.46±105.54)μg/L,(240.53±45.26)μmol/L vs.(284.52±52.47)μmol/L,(12.05±1.87)mmol/L vs.(15.79±1.87)mmol/L,the difference was statistically significant(t=17.88,4.01 and 8.62;P<0.01);left ventricular end-diastolic dimension(LVEDD)after treatment in the observation group was significantly lower than that in the control group:(46.12±1.05)mm vs.(48.81±1.74)mm,left ventricular ejection fraction(LVEF)and cardiac index(CI)were significantly higher than those in the control group:(49.95±2.17)%vs.(45.24±3.22)%,(2.98±0.55)L/(min·m2)vs.(2.45±0.73)L/(min·m2),the difference was statistically significant(t=7.67,8.38 and 3.66;P<0.01);the blood gas index arterial partial pressure of carbon dioxide(PaCO_(2))in the observation group after treatment was significantly lower than that in the control group:(46.34±3.52)mmHg(1 mmHg=0.133 kPa)vs.(51.63±4.25)mmHg,arterial partial pressure of oxygen(PaO_(2)),oxygen saturation of haemoglobin(SO_(2)),pH,HCO3-,base excess(BE)were significantly higher than the control group:(69.35±5.12)mmHg vs.(62.45±4.86)mmHg,(90.46±4.02)%vs.(85.36±4.

关 键 词：心力衰竭 肾功能不全 血气分析 沙库巴曲缬沙坦 海昆肾喜 

分 类 号：R692[医药卫生—泌尿科学] R541.6[医药卫生—外科学]