沙库巴曲缬沙坦治疗慢性心力衰竭患者心功能及氧自由基的变化  

The effect of sacubitril/valsartan on heart function and oxygen free radicals in patients with chronic heart failure

作　　者：陈鹏鹏 葛乐品 唐大超 CHEN Pengpeng;GE Lepin;TANG Dachao(Department of Cardiology,Wenzhou Traditional Chinese Medicine Hospital,Wenzhou 325000,China;不详)

机构地区：[1]温州市中医院心内科,325000

出　　处：《心电与循环》2022年第6期553-557,562,共6页Journal of Electrocardiology and Circulation

摘　　要：目的探讨沙库巴曲缬沙坦对慢性心力衰竭(下称心衰)患者心功能及氧自由基的变化。方法选择2017年10月至2020年10月温州市中医院慢性心衰患者196例,采用随机数字表法分为观察组和对照组各98例。两组患者均行常规治疗。对照组加用缬沙坦80 mg/d,1次/d,观察组加用用沙库巴曲缬沙坦50 mg/d,2次/d,均治疗8周。比较两组患者治疗前后的临床疗效、再次住院率。行超声心动图检查,检测两组患者治疗前后左心室射血分数(LVEF)、心脏指数(CI)、左心室收缩末期内径(LVESd)、左心室舒张末期内径(LVEDd)水平,行6 min步行试验,检测N末端脑钠肽前体水平(NT-proBNP)及氧自由基指标[丙二醛(MDA)、超氧化物歧化酶(SOD)、脂质过氧化物(LPO)、一氧化氮(NO)、人晚期氧化蛋白(AOPP)水平]并比较,采用美国堪萨斯城心肌病患者生存质量量表(KCCQ)评价生活质量,比较两组患者的不良反应。结果观察组临床有效率高于对照组,再次住院率低于对照组,差异均有统计学意义(均P<0.05)。治疗后,两组患者的LVEF、CI高于治疗前,LVESd、LVEDd低于治疗前,观察组LVEF、CI高于对照组,LVESd、LVEDd低于对照组,差异均有统计学意义(均P<0.05)。治疗后,两组患者6 min步行试验距离高于治疗前,NT-proBNP水平低于治疗前,差异均有统计学意义(均P<0.05)。观察组6 min步行试验距离高于对照组,NT-proBNP水平低于对照组,差异均有统计学意义(均P<0.05)。治疗后,两组患者MDA、AOPP、LPO水平低于治疗前,SOD、NO水平高于治疗前,差异均有统计学意义(均P<0.05)。治疗后,观察组MDA、AOPP、LPO水平低于对照组,SOD、NO水平高于对照组,差异均有统计学意义(均P<0.05)。治疗后,两组患者KCCQ各维度评分高于治疗前,观察组高于对照组,差异均有统计学意义(均P<0.05)。结论沙库巴曲缬沙坦有利于改善心功能及降低氧自由基含量。Objective To investigate the therapeutic effect of sacubitril/valsartan on heart function and oxygen free radical in patients with chronic heart failure(CHF).Methods A total of 196 CHF patients admitted to Wenzhou Tradi-tional Chinese Medicine Hospital from October 2017 to October 2020 were selected and randomly divided into observation group(n=98)and control group(n=98).On the basis of routine treatment,the control group was treated with valsartan,and the observation group was treated with sacubitril/valsartan for 8 weeks.The clinical efficacy,readmission rate,left ventricular ejection fraction(LVEF),cardiac index(CI),left ventricular end systolic diameter(LVESd)and end diastolic diameter(LVEDd)],malondialdehyde(MDA),superoxide dismutase(SOD)],6-minute walking distance,N-terminal pro-brain natriuretic peptide(NT-proBNP),quality of life score and adverse reactions were compared between the two groups.Results The efficacy was significantly higher and the rate of rehospitalization was significantly lower in the observation group than in the control group(all P<0.05).LVEF and CI were significantly higher,LVESd and LVEDd were significantly lower after treatment than before treatment in both groups(all P<0.05).After treatment,LVEF and CI in the observation group were significantly higher than those in the control group,and LVESd and LVEDd were significantly lower than those in the control group(all P<0.05).6-minute walking distance increased and NT proBNP decreased significantly in both groups after treatment(all P<0.05),and more significantly in the observa-tion group than in the control group(all P<0.05).After treatment,MDA,AOPP and LPO in both groups were significantly lower than those before treatment,and SOD and NO were significantly higher than those before treatment(all P<0.05).MDA,AOPP and LPO in the observation group were significantly lower than those in the control group,and SOD and NO were significantly higher than those in the control group(all P<0.05).KCCQ score increased significantly in both groups aft

关 键 词：沙库巴曲缬沙坦 心力衰竭 氧自由基 

分 类 号：R541.6[医药卫生—心血管疾病]