沙库巴曲缬沙坦钠片治疗扩张型心肌病心力衰竭的效果研究  

Effect of sacubitril/valsartan sodium tablets on heart failure in patients with dilated cardiomyopathy

作　　者：张锋[1] 尤菲 王磊[1] 马前锋 Zhang Feng;You Fei;Wang Lei;Ma Qianfeng(Department of Cardiology,Xi'an Central Hospital Affiliated to Xi'an Jiaotong University,Xi'an 710003,China)

机构地区：[1]西安交通大学附属西安市中心医院心内科,西安710003

出　　处：《中国实用医刊》2024年第15期97-100,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨沙库巴曲缬沙坦钠片治疗扩张型心肌病(DCM)心力衰竭(HF)的效果。方法队列研究。抽取2021年6月至2023年12月西安交通大学附属西安市中心医院收治的150例DCM伴HF患者为研究对象,按照双色球法分为对照组和观察组,每组75例。两组均给予常规治疗,在此基础上,对照组加用缬沙坦胶囊,观察组加用沙库巴曲缬沙坦钠片。比较两组治疗效果、超声心动图指标[左室射血分数(LVEF)、左室每搏输出量(LVSV)、左室舒张末期容积(LVESD)、左室收缩末期容积(LVESV)]、炎性因子[白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)]水平、心肌损伤指标[心肌肌钙蛋白I(cTnI)、嗜铬粒蛋白A(CgA)、可溶性细胞间黏附分子-1(sICAM-1)、N末端B型利钠肽前体(NT-proBNP)]及不良反应发生情况。结果观察组总有效率(97.33%,73/75)高于对照组(86.67%,65/75),P<0.05。治疗后,观察组LVEDV、LVESV低于对照组(P<0.05),LVEF、LVSV高于对照组(P<0.05);治疗后,观察组TNF-α、hs-CRP、IL-6水平低于对照组(P<0.05);治疗后,观察组cTnI、NT-proBNP、CgA、sICAM-1水平低于对照组(P<0.05)。两组不良反应发生率比较差异未见统计学意义(P>0.05)。结论DCM伴HF患者予以沙库巴曲缬沙坦钠片方案治疗,相比缬沙坦而言,除了可提高疗效外,还能更好地改善其心肌受损情况,提升心功能,减轻炎症反应,且安全性好。Objective To investigate the efficacy of sacubitril/valsartan sodium tablets in the treatment of dilated cardiomyopathy(DCM)complicated by heart failure(HF).Methods A total of 150 patients with DCM complicated by HF who were admitted to Xi’an Central Hospital Affiliated to Xi’an Jiaotong University were selected for the cohort study.And they were divided into a control group and an observation group by two-color ball method,with 75 cases in each group.Both groups received routine treatment;in addition,the control group received valsartan capsules,and the observation group received sacubitril/valsartan sodium tablets.The therapeutic effects,echocardiographic indicators,including left ventricular ejection fraction(LVEF),left ventricular stroke volume(LVSV),left ventricular end diastolic volume(LVESD)and left ventricular end systolic volume(LVESV),levels of inflammatory factors,including interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α),myocardial injury indicators,including cardiac troponin I(cTnI),chromogranin A(CgA),soluble intercellular adhesion molecule-1(sICAM-1)and N-terminal B-type natriuretic peptide(NT-proBNP),and incidence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group(97.33%,73/75)was higher than that of the control group(86.67%,65/75),P<0.05.After treatment,LVEDV and LVESV in the observation group were lower than those in the control group(P<0.05),while LVEF and LVSV were higher than those in the control group(P<0.05).After treatment,the levels of TNF-α,hs-CRP and IL-6 in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of cTnI,NT-proBNP,CgA and sICAM-1 in the observation group were lower than those in the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions Compared with valsartan,sacubitril/valsartan sodium tablets in the treatment

关 键 词：扩张型心肌病 心力衰竭 沙库巴曲缬沙坦钠片 炎性因子 超声心动图指标 心肌损伤指标 

分 类 号：R542.2[医药卫生—心血管疾病] R541.6[医药卫生—内科学]