沙库巴曲缬沙坦治疗高原性心脏病心力衰竭患者的疗效观察  

Efficacy of Sacubitril/Valsartan in Patients with Heart Failure of High Altitude Heart Disease

作　　者：方媛[1] 杜宣运 Fang Yuan;Du Xuanyun(Cardiovascular Department of The First Affiliated hospital of Xi’an Jiaotong University,Shaanxi Xi’an 710061;Internal Medicine Department of Ali District People's Hospital,Ali Tibet 859000,China)

机构地区：[1]西安交通大学第一附属医院心内科,陕西西安710061 [2]阿里地区人民医院内科,西藏阿里859000

出　　处：《临床研究》2023年第11期30-33,共4页Clinical Research

摘　　要：目的 探讨沙库巴曲缬沙坦治疗高原性心脏病心力衰竭患者的疗效。方法 选择2022年2月至2023年2月在阿里地区人民医院心内科住院的高原性心脏病患者68例,随机分为治疗组35例,对照组33例。两组均给予β阻滞剂、利尿剂、地高辛等抗心衰药物治疗。治疗组给予沙库巴曲缬沙坦治疗,对照组给予缬沙坦治疗。治疗前和治疗6个月后分别行血液NT-proBNP化验检查、6分钟步行试验评估运动耐量,超声心动图测定左室舒张末期容积(EDV)、左室收缩末期容积(ESV)、肺动脉压和左室射血分数(LVEF)、肺动脉压、左室直径。观察两组人群心功能改善情况及心血管不良事件的发生情况。结果 治疗6个月后,治疗组和对照组的血NT-proBNP较基线时期均有下降,但治疗组(457ng/L)较对照组(823 ng/L)下降更明显,差异有统计学意义(P<0.05)。治疗组6分钟步行距离较对照组显著增加,差异有统计学意义(P<0.05),治疗组EDV和ESV较对照组显著降低,差异有统计学意义(P<0.05),且治疗组LVEF较对照组明显提高,差异有统计学意义(P<0.05),肺动脉高压也有所改善。治疗组患者的纽约心功能分级明显优于对照组,差异有统计学意义(P<0.05),此外,治疗组心血管不良事件发生率更低,差异有统计学意义(P=0.006)。结论 沙库巴曲缬沙坦和缬沙坦都可改善高原性心脏病心力衰竭患者的心功能,但沙库巴曲缬沙坦纠正心衰的效果更明显,可以有效改善患者预后。Objective To investigate the efficacy of sacubitril/valsartan in patients with heart failure of high altitude heart disease.Methods 68 patients with high altitude heart disease hospitalized in the Department of Cardiology of Ali District People's Hospital from February 2022 to February 2023 were randomly divided into 35 patients in treatment group and 33 patients in control group.Both groups were treated with β blockers,diuretics,and digoxin.The treatment group was treated with sacubitril/valsartan and the control group with valsartan.Follow-up examination includes Blood NT-proBNP,6-minute walk test,and echocardiography for left ventricular end-diastolic volume(EDV),left ventricular end-systolic volume(ESV),pulmonary artery pressure,and left ventricular ejection fraction(LVEF).The improvement of cardiac function and the occurrence of terminal survival events in the two groups were observed.Results After 6 months of treatment,blood NT-proBNP decreased in both treatment and control groups,but more significantly in the ARNI group(457 ng/L) than in the ARB group(823 ng/L)(P<0.05).The 6-minute walking distance was significantly higher in the treatment group(P<0.05),EDV and ESV were significantly lower in the control group(P<0.05),and LVEF in the treatment group(P<0.05),and pulmonary hypertension also improved.New York cardiac function classification was significantly better in the ARNI group than in the ARB group(P<0.05),and the incidence of cardiovascular adverse events was lower in the ARNI group(P=0.006).Conclusion Both sacubitril/valsartan and valsartan can improve cardiac function in patients with high altitude heart failure,but the effect of sacubitril/valsartan is more obvious in correcting heart failure,which can effectively improve patient prognosis.

关 键 词：高原性心脏病 心力衰竭 沙库巴曲缬沙坦 缬沙坦 运动耐量 

分 类 号：R541[医药卫生—心血管疾病]