沙库巴曲缬沙坦联合硝普钠治疗对老年急性心力衰竭患者的疗效观察  

Efficacy of sacubitril/valsartan combined with sodium nitroprusside for acute heart failure in elderly patients

作　　者：徐金玲 王伟[2] 张坤[2] 崔利军 Xu Jinling;Wang Wei;Zhang Kun;Cui Lijun(Interventional Center,TEDA International Cardiovascular Hospital/Tianjin Medical University Cardiovascular Institute,Tianjin 300457,China)

机构地区：[1]天津医科大学心血管病临床学院泰达国际心血管病医院介入中心,300457 [2]天津医科大学心血管病临床学院泰达国际心血管病医院内五科,300457 [3]天津医科大学心血管病临床学院泰达国际心血管病医院内六科,300457

出　　处：《中华老年心脑血管病杂志》2023年第12期1285-1288,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：天津市卫生健康科技项目(TJWJ2022QN104)。

摘　　要：目的探究沙库巴曲缬沙坦联合硝普钠对老年急性心力衰竭患者的治疗效果。方法选取2020年6月至2021年6月泰达国际心血管病医院收治的老年急性心力衰竭患者280例,随机分为对照组143例和观察组137例,对照组给药硝普钠,观察组给药硝普钠+沙库巴曲缬沙坦,比较2组患者血流动力学指标、心功能指标、血管内皮功能指标、神经激素因子指标及临床总有效率等情况。结果观察组治疗后中心静脉压、平均动脉压、肺血管阻力、外周血管阻力、左心室舒张末期内径、左心室收缩末期内径、左心室收缩末期容积、内皮素1、N末端B型钠尿肽前体、去甲肾上腺素水平低于对照组,LVEF、NO水平高于对照组(P<0.01)。观察组临床总有效率高于对照组(97.08%vs86.71%,P=0.002)。观察组不良反应发生率低于对照组(11.68%vs20.98%,P=0.036)。结论沙库巴曲缬沙坦联合硝普钠治疗可降低老年急性心力衰竭患者血流动力学和神经激素因子水平,调节心功能和血管内皮功能,且临床总有效率高于硝普钠单一治疗,不良反应发生率低于硝普钠单一治疗。Objective To investigate the cCficacy of sacubitril/valsartan combined with sodium ni-troprusside in treatment of acute heart failure(AHF)in elderly patients.Methods A total of 280 elderly AHF patients admitted in our hospital from June 2020 to June 2021 were enrolled and ran-domly divided into control group(143 cases,sodium nitroprusside treatment)and observation group(137 cases,sodium nitroprusside±sacubitril/valsartan).Their indicators in hemodynamics,cardiac function and vascular endothelial function,neurohormone factors and clinical total effec-tive rate were compared between 2 groups.Results After treatment,the observation group ob-tained significantly lower central venous pressure,mean arterial pressure,pulmonary vascular re-sistance,peripheral vascular resistance,left ventricular end-diastolic diameter,left ventricular end-systolic diameter,left ventricular end systolic volume,and levels of endothelin 1,N-terminal-type B natriuretic peptide precursor and noradrenaline,but higher LVEF and NO levels than the con-trol group(P<0.01).The total effective rate was statistically higher(97.08%vs 86.71%,P=0.002),but the incidence of adverse reactions was notably lower(11.68%vs 20.98%,P=0.036)in the observation group than the control group.Conclusion The combined treatment reduces he-modynamic indicators and neurohormone factors,and regulates the cardiac function and vascular endothelial function in elderly AHF patients.lt is superior to sodium nitroprusside monotherapy with better total effectiveness but lower incidence of adverse reactions.

关 键 词：心力衰竭 硝普盐 缬沙坦 疗效比较研究 

分 类 号：R541.6[医药卫生—心血管疾病]