沙库巴曲缬沙坦治疗高龄老年非射血分数减低心力衰竭患者的疗效及安全性  

Curative effect and safety of sakubatril-valsartan in elderly patients with non-heart failure with reduced ejection fraction

作　　者：武云涛 田国祥[1] 陈艳梅 刘立新[1] 毕磊 姚璐 朱润秀 Wu Yuntao;Tian Guoxiang;Chen Yanmei;Liu Lixin;Bi Lei;Yao Lu;Zhu Runxiu(Department of Geriatric Medicine,Seventh Medical Center,Chinese PLA General Hospital,Beijing 100700,China;不详)

机构地区：[1]解放军总医院第七医学中心老年医学科,北京100700 [2]内蒙古自治区人民医院神经内科,呼和浩特市010017

出　　处：《中国循证心血管医学杂志》2023年第12期1314-1317,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：军队保健专项课题(15BJZ03);内蒙古科技资助课题(2021GG0123)。

摘　　要：目的观察沙库巴曲缬沙坦钠片对高龄老年非射血分数减低心力衰竭(non-HFrEF)患者的有效性及安全性。方法选取2018年1月至2020年12月于解放军总医院第七医学中心老年医学科就诊的non-HFrEF患者100例,根据是否使用沙库巴曲缬沙坦钠片分为观察组57例,对照组43例。观察其治疗前、治疗6个月后纽约心脏病协会(NYHA)心功能分级改善率、6 min步行距离(6MWD)、N末端脑钠肽前体(NT-ProBNP)、左室射血分数(LVEF)的变化及不良反应发生情况。结果治疗6个月后观察组患者心功能明显改善、生活质量明显提高,心功能分级改善率明显提高,与治疗前相比,总6MWD高于治疗前[(299.6±42.9)vs.(118.1±36.1),P<0.05];NT-ProBNP低于治疗前[(2190.2±531.8)vs.(9718.1±380.1)pg/ml,P<0.05];LVEF治疗前后无明显变化[(52.7±2.1)vs.(51.0±2.1),P<0.05]。与对照组比较心功能分级改善率明显提高,总6MWD高于对照组[(299.6±42.9)vs.(129.1±40.1),P<0.05],NT-proBNP低于对照组[(2190.2±531.8)vs.(4191.2.1±491.2)pg/ml,P<0.05],LVEF与对照组比较无明显变化[(52.7±2.1)vs.(50.9±1.9),P<0.05]。观察期间不良反应发生较少。结论沙库巴曲缬沙坦钠片对高龄老年non-HFrEF患者可显著增加6 min步行的总距离,减低NT-proBNP水平,改善心功能,不良反应较少,具有较好的疗效及安全性,为高龄老年non-HFrEF提高生活质量提供了新的治疗方法。Objective To observe the curative effect and safety of sakubatril-valsartan in elderly patients with non-heart failure with reduced ejection fraction(non-HFrEF).Methods The patients with non-HFrEF(n=100)were chosen from Department of Geriatric Medicine in the Seventh Medical Center of Chinese PLA General Hospital from Jan.2018 to Dec.2020,and they were divided,according to using or not using sakubatril-valsartan,into observation group(n=57)and control group(n=43).The changes of recovery rate of NYHA classification of heart function,6-minute walk distance(6MWD),N-terminal pro-brain natriuretic peptide(NT-proBNP)and left ventricular ejection fraction(LVEF),and incidence of adverse reactions were observed in 2 groups before treatment and after treatment for 6 months.Results In observation group,heart function,quality of life and recovery rate of NYHA classification of heart function were significantly improved after treatment for 6 months.Compared with before treatment,the total 6MWD was higher[(299.6±42.9)vs.(118.1±36.1),P<0.05],NT-ProBNP was lower[(2190.2±531.8)vs.(9718.1±380.1)pg/ml,P<0.05],and LVEF had no significant changes[(52.7±2.1)vs.(51.0±2.1),P<0.05]in observation group after treatment.The total 6MWD was higher[(299.6±42.9)vs.(129.1±40.1),P<0.05],NT-proBNP was lower[(2190.2±531.8)vs.(4191.2.1±491.2)pg/ml,P<0.05]in observation group than those in control group,and LVEF had no significant changes[(52.7±2.1)vs.(50.9±1.9),P>0.05]in observation group compared with control group.The adverse reactions were less during observation period.Conclusion Sacubitril-vaisartan can significantly promote the total 6MWD,reduce NT-ProBNP level and improve heart function with less adverse reactions.Sacubitril-vaisartan has higher curative effect and safety,which provides a new therapeutic method for elder patients with non-HFrEF.

关 键 词：沙库巴曲缬沙坦 非射血分数减低心力衰竭 老年 疗效 

分 类 号：R514.6[医药卫生—内科学]