不同剂量沙库巴曲缬沙坦治疗扩张型心肌病心力衰竭的效果比较  

Comparison of Effects on Different Doses of Sacubitril Valsartan in the Treatment of Dilated Cardiomyopathy with Heart Failure

作　　者：杨光耀 武子举 李晓亮 YANG Guangyao;WU Ziju;LI Xiaoliang(Department of Cardiology,Pingdingshan Second People’s Hospital,Pingdingshan 467000,Henan,China)

机构地区：[1]平顶山市第二人民医院心内科,河南平顶山467000

出　　处：《中国药物滥用防治杂志》2024年第5期879-882,共4页Chinese Journal of Drug Abuse Prevention and Treatment

摘　　要：目的:比较不同剂量沙库巴曲缬沙坦辅助治疗扩张型心肌病(dilated cardiomyopathy,DCM)心力衰竭患者的效果。方法:根据随机数字表法将2019年8月—2022年9月来本院接受治疗的92例DCM心力衰竭患者分为低剂量组46例与高剂量组46例。两组患者给予不同起始剂量的沙库巴曲缬沙坦片,低剂量组起始剂量50 mg,高剂量组起始剂量100 mg,比较两组心肌血清学指标、超声心动图指标以及相关不良反应的发生情况。结果:治疗1个月后,两组D-dimer、hs-cTnT、NT-proBNP水平低于治疗前(P<0.05),但低剂量组与高剂量比较,差异无统计学意义(P>0.05);两组LVEF、CVP、PAWP水平高于治疗前,LVESD水平低于治疗前(P<0.05),但低剂量组与高剂量比较,差异无统计学意义(P>0.05);高剂量组不良反应总发生率为21.74%,高于低剂量组的6.52%(P<0.05)。结论:以50 mg/次为初始剂量(低剂量)服用沙库巴曲缬沙坦进行辅助治疗的效果与高剂量效果相当,可有效改善患者的心功能情况,抑制心室重构的影响,且不良反应发生率低,安全性较好。Objective:To compare the effects of different doses of sacubitril valsartan in the adjuvant treatment of patients with dilated cardiomyopathy(DCM)and heart failure.Methods:According to the random number table method,92 patients with DCM heart failure who were treated in our hospital from August 2019 to September 2022 were divided into low-dose group(46 cases)and high-dose group(46 cases).Two groups of patients were given different initial doses of sacubitril valsartan tablets.The initial dose of the low-dose group was 50 mg,and the initial dose of the high-dose group was 100 mg.The myocardial serological indexes,echocardiographic indexes and related adverse reactions were compared between the two groups.Results:After one month of treatment,the levels of D-dimer,hs-cTnT and NT-proBNP in the two groups were lower than those before treatment(P<0.05),but there was no significant difference between the low-dose group and the high-dose group(P>0.05).The levels of LVEF,CVP and PAWP in the two groups were higher than those before treatment,and the level of LVESD in the two groups was lower than that before treatment(P<0.05).However,there was no significant difference between the low-dose group and the high-dose group(P>0.05).The total incidence of adverse reactions in the high-dose group was 21.74%,which was higher than 6.52%in the low-dose group(P<0.05).Conclusion:The effect of sacubitril valsartan with 50 mg/time as the initial dose(low dose)as the adjuvant therapy is equivalent to that of high dose,which can effectively improve the cardiac function of patients,inhibit the impact of ventricular remodeling,and has a low incidence of adverse reactions and good safety.

关 键 词：心力衰竭 扩张型心肌病 诺欣妥 沙库巴曲缬沙坦 心室重构 

分 类 号：R541.6[医药卫生—心血管疾病]