沙库巴曲缬沙坦在慢性肾脏病患者中的应用  

Application of sacubitril/valsartan in patients with chronic kidney disease

作　　者：何易 钟慧[2] 薛痕[1] 杨有芹 赵敏[1] 常晓东[1] 陈茂丽 付平[2] He Yi;Zhong Hui;Xue Hen;Yang Youqin;Zhao Min;Chang Xiaodong;Chen Maoli;Fu Ping(Department of Nephrology,Yaan People's Hospital,Yaan 625000,China;Kidney Research Institute,Department of Nephrology,West China Hospital of Sichuan University,Chengdu 610041,China)

机构地区：[1]雅安市人民医院肾脏内科四川大学华西医院雅安医院,雅安625000 [2]四川大学华西医院肾脏内科华西肾脏病研究所,成都610041

出　　处：《中华肾脏病杂志》2024年第1期67-73,共7页Chinese Journal of Nephrology

基　　金：四川大学华西医院学科卓越发展1·3·5工程临床研究孵化项目(19HXFH050)。

摘　　要：沙库巴曲缬沙坦(sacubitril/valsartan,LCZ696)作为在慢性肾脏病(chronic kidney disease,CKD)患者中应用的新策略,许多证据表明其改善了CKD患者的预后。该综述通过检索万方、中国知网、PubMed等数据库中LCZ696上市以来其在CKD患者中应用的相关文章,总结其在生理、病理、药理、临床应用等方面的作用。虽然沙库巴曲的活性产物LBQ657在中度、重度肾损伤和终末期肾脏病患者中的药物累积量较高,在血液透析中不被清除,在腹膜透析中清除极少,但并不影响其安全性。与血管紧张素转换酶抑制剂、血管紧张素受体拮抗剂类药物相比,LCZ696可以提高血压达标率,改善心功能,使肾小球滤过率下降速度减慢,使心血管结局得到改善,且无更多不良事件发生。LCZ696可在各级CKD合并高血压和/或心力衰竭的患者中应用,安全性及耐受性可靠。As a new strategy for the application of sacubitril/valsartan(LCZ696)in patients with CKD,much evidence showed that it improved the prognosis of patients with CKD.This review summarizes the efficacy and safety of sacubitril/valsartan in physiology,pathology,pharmacology and clinical application by searching Wanfang,CNKI,PubMed and other databases for related articles on the application of sacubitril/valsartan in CKD patients.Although LBQ657,the active product of sacubitril,has a high drug accumulation in patients with moderate,severe renal injury,and ESRD,it is not cleared in hemodialysis,and has very little eliminated in peritoneal dialysis,which does not affect its safety.Compared with angiotensin converting enzyme inhibitor and angiotensin receptor blocker drugs,LCZ696 could increase the blood pressure control rate,improve cardiac function,slow down the decline of glomerular filtration rate,and significantly improve cardiovascular outcomes without more adverse events.Sacubitril/valsartan can be used in all levels of CKD patients complicated with hypertension and/or heart failure,with reliable safety and tolerance.

关 键 词：缬沙坦 肾功能不全 慢性 心力衰竭 高血压 慢性肾脏病 沙库巴曲 

分 类 号：R692[医药卫生—泌尿科学]