沙库巴曲缬沙坦钠治疗顽固性心力衰竭的疗效分析  

Analysis of curative effect of sacubitril valsartan sodium in the treatment of refractory heart failure

作　　者：孙辉[1] 张晶[1] SUN Hui;ZHANG Jing(Dalian Medical University Affiliated Second Hospital,Dalian 116023,China)

机构地区：[1]大连医科大学附属第二医院,116023

出　　处：《中国实用医药》2023年第20期6-10,共5页China Practical Medicine

摘　　要：目的分析顽固性心力衰竭(HF)采取沙库巴曲缬沙坦钠治疗的效果。方法70例顽固性HF患者,按照入院先后顺序分为对照组(先入院)和观察组(后入院),每组35例。两组患者均采取综合治疗,在此基础上,对照组口服坎地沙坦酯治疗,观察组口服沙库巴曲缬沙坦钠治疗。比较两组患者治疗前后心功能指标[每搏输出量(SV)、左室射血分数(LVEF)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)]、血清指标[醛固酮(ALD)、N末端B型脑钠肽前体(NT-proBNP)、细胞间粘附分子-1(ICAM-1)]、心肌损伤指标[心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、心型脂肪酸结合蛋白(H-FABP)]、氧化应激反应指标[丙二醛(MDA)、总抗氧化能力(TAC)、过氧化脂质(LPO)]、6 min步行距离、明尼苏达州心功能不全生活质量量表(MLHFQ)评分及治疗效果。结果治疗后,观察组患者SV(56.93±4.01)ml、LVEF(53.85±3.55)%高于对照组的(50.67±3.84)ml、(41.58±3.43)%,LVESD(45.26±2.07)mm、LVEDD(58.30±3.10)mm小于对照组的(48.02±2.85)、(60.39±3.06)mm,差异具有统计学意义(P<0.05)。治疗后,观察组患者ALD水平(31.14±5.75)pg/ml、NT-proBNP水平(409.55±21.37)pg/ml、ICAM-1水平(31.41±3.17)μg/L均低于对照组的(37.93±5.79)pg/ml、(459.63±22.01)pg/ml、(39.64±3.26)μg/L,差异具有统计学意义(P<0.05)。治疗后,观察组患者cTnI水平(0.16±0.05)μg/L、CK-MB水平(18.30±2.12)U/L、LDH水平(183.43±18.36)U/L、H-FABP水平(2.32±0.31)ng/ml均低于对照组的(0.68±0.08)μg/L、(31.25±3.12)U/L、(245.55±24.30)U/L、(4.50±0.55)ng/ml,差异具有统计学意义(P<0.05)。治疗后,观察组患者MDA水平(3.26±0.40)nmol/ml、LPO水平(3.46±0.47)nmol/L均低于对照组的(4.64±0.58)nmol/ml、(4.28±0.55)nmol/L,TAC水平(16.14±1.88)U/ml高于对照组的(12.74±1.83)U/ml,差异具有统计学意义(P<0.05)。治疗后,观察组患者6 min步行距离(352.20±34.14)m长于对照组的(332.86±30.0Objective To analyze the effect of sacubitril valsartan sodium in the treatment of refractory heart failure(HF).Methods A total of 70 patients with refractory HF were divided into control group(admitted first)and observation group(admitted later)according to the order of admission,with 35 cases in each group.Patients in both groups received comprehensive treatment.On this basis,the control group was treated with oral cndesartan cilexetil,and the observation group was treated with oral sacubactril valsartan sodium.Both groups were compared in terms of cardiac function indexes[stroke volume(SV),left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD)],serum indicators[aldosterone(ALD),N-terminal pro-B-type natriuretic peptide(NT-proBNP),cellular adhesion molecule-1(CAM-1)],myocardial injury indicators[cardiac troponin I(cTnI),creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH),heart-fatty acid binding protein(H-FABP)],oxidative stress response indicators[malondialdehyde(MDA),total antioxidant capacity(TAC),lipid peroxide(LPO)],6-min walking distance,Minnesota heart failure quality of life scale(MLHFQ)score before and after treatment,and therapeutic effect.Results After treatment,SV of(56.93±4.01)ml and LVEF of(53.85±3.55)%in the observation group were higher than those of(50.67±3.84)ml and(41.58±3.43)%in the control group;LVESD of(45.26±2.07)mm and LVEDD of(58.30±3.10)mm in the observation group were less than those of(48.02±2.85)and(60.39±3.06)mm in the control group;the difference was statistically significant(P<0.05).After treatment,the observation group had ALD level of(31.14±5.75)pg/ml,NT-proBNP level of(409.55±21.37)pg/ml and ICAM-1 level of(31.41±3.17)μg/L,which were lower than those of(37.93±5.79)pg/ml,(459.63±22.01)pg/ml and(39.64±3.26)μg/L in the control group,and the differences were statistically significant(P<0.05).After treatment,the observation group had cTnI level of(0.16±0.05)μg/L,CK-MB level of(1

关 键 词：顽固性心力衰竭 心功能 沙库巴曲缬沙坦钠 心肌损伤 氧化应激 生活质量 治疗效果 

分 类 号：R541.6[医药卫生—心血管疾病]