沙库巴曲缬沙坦钠对扩张型心肌病心衰患者NT-proBNP、CgA水平及心功能指标的影响研究  

Study of the effect of sacubitril valsartan sodium on NT-proBNP,CgA levels and cardiac function indexes in patients with heart failure caused by dilated cardiomyopathy

作　　者：邝光华 周宇明[1] KUANG Guang-hua;ZHOU Yu-ming(Department of Emergency,Ganzhou People's Hospital,Ganzhou 341000,China)

机构地区：[1]赣州市人民医院急诊科,341000

出　　处：《中国实用医药》2025年第1期1-5,共5页China Practical Medicine

摘　　要：目的研究扩张型心肌病(DCM)心力衰竭(心衰,HF)患者使用沙库巴曲缬沙坦钠治疗后对氨基末端B型利钠肽前体(NT-proBNP)、嗜铬粒蛋白A(CgA)和心功能指标的影响。方法选取60例DCM心衰患者作为观察组,根据随机双盲法将观察组患者分为A组与B组,各30例;另选取同期30例健康体检者作为对照组。对照组不进行任何治疗,观察组给予利尿剂、强心剂和硝酸酯类等常规药物治疗,在此基础上A组行培哚普利治疗,B组行沙库巴曲缬沙坦钠治疗。比较观察组与对照组、A组与B组的临床基本资料,观察组治疗前与对照组的CgA、NT-proBNP水平,A组与B组治疗前后的血清指标(CgA和NT-proBNP)和心功能指标[左室射血分数(LVEF)、左室收缩末期容积(LVESV)和左室舒张末期容积(LVEDV)]。结果观察组与对照组、A组与B组的年龄、性别、体质量指数(BMI)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、收缩压、舒张压比较差异无统计学意义(P>0.05)。对照组CgA、NT-proBNP水平低于观察组及观察组美国纽约心脏病学会(NYHA)分级Ⅱ、Ⅲ、Ⅳ级患者(P<0.05);观察组NYHA分级Ⅳ级患者CgA、NT-proBNP水平高于Ⅲ、Ⅱ级患者,且NYHA分级Ⅲ级患者CgA、NT-proBNP水平高于Ⅱ级患者(P<0.05)。治疗后,A组的LVEF(31.49±2.52)%明显低于B组的(33.79±3.11)%(P<0.05);B组的NT-proBNP(1534.20±1249.31)pg/ml、CgA(164.20±76.57)ng/ml、LVEDV(159.23±23.75)ml和LVESV(109.06±14.84)ml均明显低于A组的(2139.35±1032.66)pg/ml、(213.10±100.17)ng/ml、(176.52±38.17)ml、(129.26±27.68)ml(P<0.05)。观察组NT-proBNP与LVESV、LVEDV呈正相关(r=0.701、0.706,P<0.01),与LVEF呈负相关(r=-0.390,P<0.01);CgA与LVEF呈负相关(r=-0.649,P<0.01),与LVESV和LVEDV呈正相关(r=0.569、0.585,P<0.01);NT-proBNP与CgA呈正相关(r=0.602,P<0.01)。结论DCM心衰患者使用沙库巴曲缬沙坦钠治疗可有效改善心功能和降低CgA水平的表�Objective To study the effects of sacubitril valsartan sodium on N-terminal B-type natriuretic peptide precursor(NT-proBNP),chromogranin A(CgA)and cardiac function indexes in patients with heart failure(HF)caused by dilated cardiomyopathy(DCM).Methods 60 patients with heart failure caused by DCM were selected as the observation group.According to the randomized double-blind method,the patients in the observation group were divided into group A and group B,each with 30 cases;another 30 healthy medical check-ups in the same period were selected as the control group.No treatment was given to the control group,and the observation group was given conventional medication such as diuretics,cardiotonic agents and nitrates,on the basis of which group A was treated with perindopril and group B was treated with sacubitril valsartan sodium.The basic clinical data of the observation group and the control group was compared,as well as the levels of CgA and NT-proBNP in the observation group before treatment and the control group,and the serum indexes(CgA and NT-proBNP)and cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end-systolic volume(LVESV),and left ventricular end-diastolic volume(LVEDV)]before and after the treatment in group A and group B.Results There was no significant difference in age,gender,body mass index(BMI),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),fasting plasma glucose(FPG),systolic blood pressure and diastolic blood pressure between the observation group and the control group,and between group A and group B(P>0.05).The levels of CgA and NT-proBNP in the control group were lower than those in the observation group and those of New York Heart Association(NYHA)classⅡ,ⅢandⅣpatients in the observation group(P<0.05).In the observation group,the levels of CgA and NT-proBNP in NYHA classⅣpatients were higher than those in classⅢandⅡpatients;the levels of CgA and NT-proBNP in NYHA classⅢpatients were h

关 键 词：沙库巴曲缬沙坦钠 扩张型心肌病 心力衰竭 氨基末端B型利钠肽前体 嗜铬粒蛋白A 心功能指标 左室射血分数 

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