沙库巴曲缬沙坦治疗舒张性心力衰竭疗效及对外周血NT-proBNP的影响  

The therapeutic effect of sacubitril and valsartan on patients with diastolic heart failure and its effect on serum N-terminal B-type natriuretic peptide

作　　者：牛丽霞 Niu Lixia(Department of Cardiology,Tianjin Hexi Hospital,Tianjin 300202,China)

机构地区：[1]天津市河西医院,天津300202

出　　处：《首都食品与医药》2024年第9期57-59,共3页Capital Food Medicine

摘　　要：目的探讨沙库巴曲缬沙坦治疗舒张性心衰患者疗效及对外周血N末端B型钠尿肽前体(NT-proBNP)的影响.方法回顾性分析天津市河西医院心内科近5年来收治的89例舒张性心衰患者为研究对象.45例采用常规治疗,包括调整及应用利尿剂、β受体阻滞剂、ARB/ACEI、醛固酮受体拮抗剂、扩血管等常规抗心衰药物(对照组).44例患者在常规治疗基础上加用沙库巴曲缬沙坦(观察组).观察两组治疗3个月后临床疗效、血流动力学及血清学相关指标是否存在差异.结果观察组显效20例,有效16例,无效8例,总有效率为81.8%,显著高于对照组总有效率的62.2%,且差异有统计学意义(P<0.05);治疗后观察组6M步行试验结果显著高于对照组(P<0.05);而外周血NT-proBNP、LVEDVI、LVESVI及左房容量指数LAVI显著低于对照组,且差异均有统计学意义(P<0.05);观察组和对照组治疗前NT-proBNP分别为(2.44±1.43)μg/mL和(2.39±1.55)μg/mL,治疗后分别为(0.47±0.23)μg/mL和(0.68±0.21)μg/mL,观察组显著低于对照组,且有统计学差异(P<0.05).以治疗后外周血NT-proBNP为参考预测沙库巴曲缬沙坦治疗舒张性心衰患者显效的敏感性为68.0%(95%CI:48.41%-82.79%),特异性为64.2%(95%CI:41.04%-80.85%),ROC曲线下面积为0.74(95%CI:0.59-0.89).结论沙库巴曲缬沙坦可能通过降低舒张性心衰患者外周血NT-proBNP水平改善患者舒张功能,提高临床疗效.Objective To explore the therapeutic effect of sacubitril valsartan on patients with diastolic heart failure and its effect on serum N-terminal B-type natriuretic peptide.Method A retrospective analysis was conducted on 89 patients with diastolic heart failure admitted to the cardiology department of Hexi Hospital in Tianjin over the past 5 years.45 cases received routine treatment including adjustment and application of diureticsβconventional anti heart failure drugs such as receptor blockers,ARB/ACEI,aldosterone receptor antagonists,and vasodilators(control group).44 patients were treated with a combination of conventional therapy and sacubitril and valsartan(observation group).Observe the differences in clinical efficacy,hemodynamics,and serum related indicators between the two groups after 3 months of treatment.Result There were 20 cases of significant improvement,16 cases of effectiveness,and 8 cases of ineffectiveness in the observation group,with a total effective rate of 81.8%,significantly higher than the total effective rate of 62.2%in the control group,and the difference was statistically significant(P<0.05);the result of 6M walking test in the observation group after treatment was significantly higher than that in the control group(P<0.05);the serum NT-proBNP,LVEDVI,LVESVI,and left atrial volume index(LAV)were significantly lower than the control group,and the differences were statistically significant(P<0.05);the NT-proBNP values before treatment in the observation group and control group were respectively(2.44±1.43)μg/mL,and(2.39±1.55)μg/mL,after treatment,the values were respectively(0.47±0.23)μg/mL and(0.68±0.21)μg/mL,the observation group was significantly lower than the control group,and there was a statistical difference(P<0.05).The sensitivity and specificityof predicting the efficacy of sacubitril valsartan in treating patients with diastolic heart failure using post-treatment serum NT-proBNP as a reference were 68.0%(95%CI:48.41%-82.79%)and 64.2%(95%CI:41.04%-80.85%),respectively.Th

关 键 词：舒张性心衰 沙库巴曲缬沙坦 N末端B型钠尿肽前体 临床疗效 

分 类 号：R541.6[医药卫生—心血管疾病]