沙库巴曲缬沙坦对冠心病伴慢性心力衰竭患者的血管内皮功能、sST2和PRA水平的影响  

Effects of Sacubitril Valsartan on Vascular Endothelial Function and Levels of sST2 and PRA in Patients with Coronary Heart Disease and Chronic Heart Failure

作　　者：董珍秀 邹淑梅 甄顺意 DONG Zhenxiu;ZOU Shumei;ZHEN Shunyi(Guangzhou Xinhai Hospital,Guangzhou 510000,China;不详)

机构地区：[1]广州新海医院,广东广州510000

出　　处：《中外医学研究》2023年第1期53-56,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探究沙库巴曲缬沙坦对冠心病(CHD)伴慢性心力衰竭(CHF)患者血管内皮功能和可溶性生长刺激表达基因2(sST2)、血浆肾素活性(PRA)水平的影响。方法:选取2020年1月-2022年1月在广州新海医院确诊的104例CHD伴CHF患者,随机分为观察组(n=52,采用沙库巴曲缬沙坦进行治疗)和对照组(n=52,采用缬沙坦治疗),均持续用药3个月。分别于治疗前和治疗3个月后,分析两组心功能指标、血管内皮功能指标、血清sST2、PRA水平,同时记录两组出现疲倦、胃肠道不适、血管性水肿等用药不良反应的发生情况。结果:观察组治疗3个月后总有效率高于对照组(χ^(2)=4.265,P=0.039)。治疗前,两组心功能指标[左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)和左心室射血分数(LVEF)]、血管内皮功能指标[血管舒张功能(FMD)、内皮素-1(ET-1)、一氧化氮(NO)]、PRA、sST2水平比较差异均无统计学意义(P>0.05);两组治疗3个月后LVEF、FMD、NO升高,LVEDD、LVESD、ET-1、PRA和s ST2降低,观察组变化更明显(P<0.05)。观察组治疗期间关于疲倦、胃肠道不适、血管性水肿的总不良反应发生率为17.31%,较对照组的36.54%更低(P<0.05)。结论:沙库巴曲缬沙坦可以明显降低s ST2、PRA水平,改善CHD伴CHF患者的心功能和血管内皮功能。Objective: To investigate the effects of Sacubitril Valsartan on vascular endothelial function, soluble growth stimulation expressed gene 2(sST2) and plasma renin activity(PRA) in patients with coronary heart disease(CHD) and chronic heart failure(CHF).Method: A total of 104 patients with CHD and CHF diagnosed in Guangzhou Xinhai Hospital from January 2020 to January 2022 were selected, which were randomly divided into the observation group(n=52, treated with Sacubitril Valsartan) and the control group(n=52,treated with Valsartan), both of which were used for 3 months. Before and 3 months after treatment, the indexes of cardiac function,vascular endothelial function, sST2 and PRA in two groups were analyzed. At the same time, the occurrence of adverse drug reactions such as fatigue, gastrointestinal discomfort and vascular edema in the two groups were recorded. Result: The total effective rate of the observation group after 3 months of treatment was significantly higher than that of the control group( χ^(2)=4.265, P=0.039). Before treatment, there were no significant differences in cardiac function [left ventricular end-systolic diameter(LVESD), left ventricular enddiastolic diameter(LVEDD), and left ventricular ejection fraction(LVEF)], vascular endothelial function [flow-mediated dilation(FMD),endothelin-1(ET-1), nitrous oxide(NO)], serum PRA and sST2 between the two groups(P>0.05). After 3 months of treatment, the levels of LVEF, FMD and NO significantly increased, the levels of LVEDD, LVESD, ET-1, PRA and sST2 significantly decreased in the two groups, the change was more obvious in the observation group(P<0.05). During the treatment, the total incidence of adverse reactions such as fatigue, gastrointestinal discomfort and angioedema in the observation group was 17.31%, lower than 36.54% in the control group(P<0.05). Conclusion: Sacubitril Valsartan can significantly reduce levels of sST2 and PRA, and improve cardiac function and vascular endothelial function in patients with CHD and CHF.

关 键 词：冠心病 慢性心力衰竭 沙库巴曲缬沙坦 缬沙坦 可溶性生长刺激表达基因2 血浆肾素活性 

分 类 号：R541.4[医药卫生—心血管疾病] R541.6[医药卫生—内科学]