沙库巴曲缬沙坦钠片-养心颗粒序贯治疗射血分数减少的心力衰竭伴肾功能不全患者的效果  

The effect of sequential therapy with sacubitril valsartan sodium tablets and Yangxin granules on patients with heart failurewith reduced ejection fraction complicated with renal insufficiency

作　　者：杨小杰 马祥雨 魏阗欣 YANG Xiaojie;MA Xiangyu;WEI Tianxin(Department of Internal Medicine,Gongqingcheng People's Hospital,Jiujiang,Jiangxi,332020,China;Department of Clinical Laboratory,Gongqingcheng People's Hospital,Jiujiang,Jiangxi,332020,China;Department of Cardiology,Gongqingcheng People's Hospital,Jiujiang,Jiangxi,332020,China)

机构地区：[1]共青城市人民医院内科,江西九江332020 [2]共青城市人民医院检验科,江西九江332020 [3]共青城市人民医院心内科,江西九江332020

出　　处：《当代医学》2024年第22期17-21,共5页Contemporary Medicine

摘　　要：目的探讨沙库巴曲缬沙坦钠片-养心颗粒序贯治疗射血分数减少的心力衰竭(heart failure with reduced ejection fraction,HFrEF)伴肾功能不全患者的效果。方法选取2019年10月至2022年10月共青城市人民医院收治的84例HFrEF伴肾功能不全患者作为研究对象,按照随机抽签法分为实验组与对照组,各42例。两组患者均给予常规治疗,在此基础上,对照组采用沙库巴曲缬沙坦钠片治疗,实验组采用沙库巴曲缬沙坦钠片-养心颗粒序贯治疗。比较两组治疗前后心功能[左心室射血分数(left vemtricular ejection fractions,LVEF)、左心室舒张末期内径(left ventricular end-diastolic dimension,LVEDD)与6 min步行试验(6 min walk test,6MWT)]、肾功能[血肌酐(serum creatinine,SCr)、尿素氮(urea nitrogen,BUN)、尿蛋白排泄率(urinary protein excretion rate,UAER)]、血清中胱抑素C(cystatin C,CysC)、半乳糖凝聚素3(galactoagglutinin 3,Gal-3)、N末端B型钠尿肽原(N-terminal pro-brain natriuretic peptide,NT-proBNP)、电解质血清钾、钠、钙水平及治疗期间不良反应发生情况。结果治疗后,实验组LVEDD短于治疗前,两组LVEF均高于治疗前,6MWT长于治疗前,且实验组LVEDD短于对照组,LVEF高于对照组,6MWT长于对照组,差异有统计学意义(P<0.05)。治疗后,两组SCr、BUN、UAER水平均低于治疗前,且实验组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组CysC、Gal-3、NT-proBNP水平均低于治疗前,且实验组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组血清钠水平均高于治疗前,且实验组血清钾、钠、钙水平均高于对照组,差异有统计学意义(P<0.05)。实验组治疗期间不良反应发生率为14.29%,对照组为7.14%,两组不良反应发生率比较差异无统计学意义。结论沙库巴曲缬沙坦钠片-养心颗粒序贯治疗能有效改善HFrEF伴肾功能不全患者的心、肾功能,可调节血清中CysC、Gal-3及电解质水平,值得临床推�Objective To investigate the effect of sequential therapy with sacubitril valsartan sodium tablets and Yangxin granules on patients with heart failure with reduced ejection fraction(HFrEF)complicated with renal insufficiency.Methods 84 patients with HFrEF and renal insufficiency admitted to Gongqingcheng People's Hospital from October 2019 to October 2022 were selected as the research subjects,and they were divided into the experimental group and the control group according to the random lottery method,with 42 cases in each group.Both groups were given routine treatment,on this basis,the control group was treated with sacubitril valsartan sodium tablets,while the experimental group was given sequential therapy with sacubitril valsartan sodium tablets and Yangxin granules.The cardiac function(left ventricular ejection fraction[LVEF],left ventricular end-diastolic dimension[LVEDD],6 min walk test[6MWT]),renal function(serum creatinine[SCr],blood urea nitrogen[BUN],urinary albumin excretion rate[UAER]),serum cystatin C(CysC),galactoagglutinin 3(Gal-3),N-terminal pro-brain natriuretic peptide(NT-proBNP)and electrolytes such as serum potassium,sodium and calcium before and after treatment and occurrence of adverse reactions during treatment were compared between the two groups.Results After treatment,LVEDD in the experimental group was shorter than that before treatment,and LVEF of the two groups were higher than that before treatment,6MWT was longer than that before treatment,and LVEDD in the experimental group was shorter than that in the control group,LVEF was higher than that in the control group,6MWT was longer than that in the control group,the differences were statistically significant(P<0.05).After treatment,the levels of SCr,BUN and UAER of the two groups were lower than those before treatment,and the experimental group was lower than the control group,the differences were statistically significant(P<0.05).After treatment,the levels of CysC,Gal-3 and NT-proBNP were lower of the two groups were lower than thos

关 键 词：养心颗粒 沙库巴曲缬沙坦钠片 心力衰竭 肾功能不全 电解质 

分 类 号：R54[医药卫生—心血管疾病]