沙库巴曲缬沙坦钠对老年慢性心力衰竭合并2型糖尿病患者肾功能、神经内分泌激素和TGF-β1/Smad3信号通路的影响  

Effects of Sacubitril Valsartan Sodium on Renal Function,Neuroendocrine Hormone and TGF-β1/Smad3 Signaling Pathway in Elderly Patients with Chronic Heart Failure Complicated with Type 2 Diabetes Mellitus

作　　者：崔东 孙立立 张旭 张大红 刘君[1] CUI Dong;SUN Li-li;ZHANG Xu;ZHANG Da-hong;LIU Jun(Department of Internal Medicine-Cardiovascular,The First Hospital of Hebei Medical University,Shijiazhuang,Hebei,050003,China)

机构地区：[1]河北医科大学第一医院心内科,河北石家庄050003

出　　处：《现代生物医学进展》2023年第16期3102-3106,共5页Progress in Modern Biomedicine

基　　金：河北省医学科学研究课题计划项目(20211711)。

摘　　要：目的:探讨沙库巴曲缬沙坦钠对老年慢性心力衰竭(CHF)合并2型糖尿病(T2DM)患者肾功能、神经内分泌激素和转化生长因子-β1(TGF-β1)/Smad3信号通路的影响。方法:选择我院2020年5月~2021年5月期间收治的92例老年CHF合并T2DM患者,按照双色球法将患者分为对照组(n=46,接受常规治疗)和研究组(n=46,对照组基础上接受沙库巴曲缬沙坦钠治疗)。对比两组心功能、肾功能、神经内分泌激素、TGF-β1/Smad3信号通路相关指标和不良反应发生情况。结果:治疗12个月后,研究组心输出量(CO)、左心室射血分数(LVEF)高于对照组,左心室舒张末期内径(LVEDD)低于对照组(P<0.05)。治疗12个月后,研究组血肌酐(Scr)、血尿素氮(BUN)、血尿酸(UA)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、胱抑素C(Cys-C)低于对照组(P<0.05)。治疗12个月后,研究组去甲肾上腺素(NE)、醛固酮(ALD)和血管紧张素II(AngII)低于对照组(P<0.05)。治疗12个月后,研究组Smad7 m RNA高于对照组,Smad2 m RNA、TGF-β1 m RNA、Smad3 m RNA低于对照组(P<0.05)。两组不良反应发生率组间比较差异无统计学意义(P>0.05)。结论:沙库巴曲缬沙坦钠用于治疗老年CHF合并T2DM患者,可有效改善患者的心功能、肾功能、神经内分泌激素和TGF-β1/Smad3信号通路相关指标,安全性较好。Objective:To investigate the effects of Sacubitril Valsartan sodium on renal function,neuroendocrine hormone and transforming growth factor-β1(TGF-β1)/Smad3 signaling pathway in elderly patients with chronic heart failure(CHF)complicated with type 2 diabetes mellitus(T2DM).Methods:92 elderly patients with CHF complicated with T2DM who were admitted to our hospital from May 2020 to May 2021 were selected,and they were divided into control group(n=46,receiving conventional treatment)and study group(n=46,receiving Sacubitril Valsartan sodium treatment on the basis of control group)according to dichromatic sphere method.Cardiac function,renal function,neuroendocrine hormone,TGF-β1/Smad3 signaling pathway related indicators and the occurrence of adverse reactions were compared in the two groups.Results:12 months after treatment,the cardiac output(CO)and left ventricular ejection fraction(LVEF)in the study group were higher than those in the control group,and the left ventricular end-diastolic diameter(LVEDD)was lower than that in the control group(P<0.05).12 months after treatment,serum creatinine(Scr),blood urea nitrogen(BUN),blood uric acid(UA),neutrophil gelatinase-associated lipocalin(NGAL)and cystatin C(Cys-C)in the study group were lower than those in the control group(P<0.05).12 months after treatment,norepinephrine(NE),aldosterone(ALD)and angiotensin II(AngII)in the study group were lower than those in the control group(P<0.05).12 months after treatment,Smad7 m RNA in the study group was higher than that in the control group,while Smad2 m RNA,TGF-β1 m RNA and Smad3 m RNA were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions in the two groups(P<0.05).Conclusion:Sacubitril Valsartan sodium is used to treat elderly patients with CHF complicated with T2DM,which can effectively improve the cardiac function,renal function,neuroendocrine hormone and TGF-β1/Smad3 signaling pathway related indicators,with a good safety.

关 键 词：沙库巴曲缬沙坦钠 老年 慢性心力衰竭 2型糖尿病 肾功能 神经内分泌激素 TGF-β1/Smad3信号通路 

分 类 号：R541.61[医药卫生—心血管疾病] R587.2[医药卫生—内科学]