沙库巴曲缬沙坦联合新活素治疗对老年急性左心衰竭患者心肌酶谱、肾功能及炎症标志物的影响  

Effect of sacubitril valsartan combined with rh-BNP on myocardial enzymes,renal function and inflammatory markers in elderly patients with acute left heart failure

作　　者：邬丹琴 周佳龙 汤燕 WU Danqin;ZHOU Jialong;TANG Yan(Department of Emergency,Haining Hospital of Traditional Chinese Medicine,Haining 314400,China)

机构地区：[1]海宁市中医院急诊科,浙江海宁314400

出　　处：《全科医学临床与教育》2023年第12期1079-1082,共4页Clinical Education of General Practice

摘　　要：目的 探究沙库巴曲缬沙坦联合新活素治疗对老年急性左心衰竭(ALHF)患者心肌酶谱、肾功能及炎症标志物的影响。方法 选取100例老年ALHF患者并依据随机数字表法分为联合组(接受沙库巴曲缬沙坦联合新活素治疗)与对照组(接受沙库巴曲缬沙坦治疗),各50例。观察并比较两组临床疗效、心肌酶谱水平、肾功能、炎症标志物以及不良反应情况。结果 联合组临床总有效率(94.00%)明显高于对照组(70.00%),差异有统计学意义(χ^(2)=9.76,P<0.05)。治疗后联合组患者肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)以及超敏C反应蛋白(hs-CRP)水平明显低于对照组(t分别=9.20、9.35、6.44、7.54、5.86,P均<0.05),而尿素氮(BUN)、肾小球滤过率(eGFR)以及血肌酐(SCr)水平均明显高于对照组(t分别=8.39、4.57、7.98,P均<0.05)。两组患者不良反应发生率比较,差异无统计学意义(χ^(2)=0.00,P>0.05)。结论 沙库巴曲缬沙坦联合新活素治疗老年ALHF患者疗效显著,对患者心肌损伤以及肾功能有显著改善作用,同时可调节各项炎症标志物水平,且联合用药不会增加不良反应。Objective To explore the effects of sacubitril valsartan(SV)combined with rh-BNP on myocardial en⁃zymes,renal function and inflammatory markers in elderly patients with acute left heart failure(ALHF).Methods A to⁃tal of 100 elderly patients with ALHF were divided into combination group(received SV combined with rh-BNP treat⁃ment)and control group(received SV treatment)according to random number table method,50 cases in each.The clini⁃cal curative effect,myocardial enzymes,renal function,inflammatory markers and adverse reactions in the two groups were observed and compared.Results There was significant difference between combination group and control group in total clinical effective rate(94.00%vs.70.00%,χ^(2)=9.76,P<0.05).After treatment,levels of creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and hypersensitive C-reactive protein(hs-CRP)were significantly lower in combination group than control group(t=9.20,9.35,6.44,7.54,5.86,P<0.05),while the levels of blood urea nitrogen(BUN),estimated glomerular filtration rate(eGFR)and serum creatinine(SCr)were significantly higher in combination group than control group(t=8.39,4.57,7.98,P<0.05).There was no significant difference in incidence of adverse reactions between combination group and control group(χ^(2)=0.00,P>0.05).Conclusion SV combined with rh-BNP has significant curative effect on elderly patients with ALHF,which can significantly improve myocardial injury and renal function,adjust levels of inflammatory markers and will not in⁃crease adverse reactions.

关 键 词：老年急性左心衰竭 心肌酶谱 疗效 肾功能 炎症标志物 沙库巴曲缬沙坦 

分 类 号：R541.6[医药卫生—心血管疾病]