沙库巴曲缬沙坦治疗Ⅱ型心肾综合征患者疗效及对AECG心率和血清Cys-C、NT-proBNP、cTnT水平的影响  

Efficacy of sacubitril/valsartan in treating patients with typeⅡcardiorenal syndrome and its influence on AECG heart rate and serum Cys-C,NT-proBNP and cTnT levels

作　　者：甘艳 樊才瑞 郑春晓 邱清勇 吕秋 张楚民 GAN Yan;FAN Cairui;ZHENG Chunxiao;QIU Qingyong;LYU Qiu;ZHANG Chumin(Department of Cardiology and Nephrology,928 Hospital of PLA Joint Logistic Support Force,Haikou 571100,China;Department of Neurosurgery,928 Hospital of Joint Logistic Support Force,PLA,Haikou 571100,China;Department of Internal Medicine,Huangjiahu Hospital,Hubei University of Traditional Chinese Medicine,Wuhan 430065,China;Department of Cardiovascular Medicine,Hainan Provincial People's Hospital,Haikou 570311,China)

机构地区：[1]中国人民解放军联勤保障部队第九二八医院心肾内科,海南海口571100 [2]中国人民解放军联勤保障部队第九二八医院神经外科,海南海口571100 [3]湖北中医药大学黄家湖医院内科,湖北武汉430065 [4]海南省人民医院心血管内科,海南海口570311

出　　处：《西部医学》2025年第2期238-242,共5页Medical Journal of West China

基　　金：海南省自然科学基金项目(820MS196)。

摘　　要：目的探讨沙库巴曲缬沙坦(Sac/Val)治疗Ⅱ型心肾综合征(CRS)患者疗效及对动态心电图(AECG)心率和血清胱抑素-C(Cys-C)、氨基末端B型钠尿肽原(NT-proBNP)、肌钙蛋白T(cTnT)水平的影响。方法选取2021年8月—2023年8月中国人民解放军联勤保障部队第九二八医院收治的108例Ⅱ型CRS患者,采用随机数字表法分为Val组(54例,常规治疗+缬沙坦)和Sac/Val组(54例,常规治疗基础上给予Sac/Val治疗)。比较两组治疗后疗效及治疗前后AECG心率[24 h内正常窦性心搏(RR)间期标准差(SDNN)、相邻RR间期相差≥50 ms的百分数(PNN50)、相邻正常RR间期差值的均方根(rMSSD)、每5 min节段的正常RR间期平均值标准差(SDANN)]、心功能[左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)]、肾功能[肾小球滤过率(GFR)、血肌酐(Scr)、尿素氮(BUN)]变化及Cys-C、NT-proBNP、cTnT水平差异;记录两组不良反应情况。结果Sac/Val组疗效高于Val组(P<0.05);治疗前,两组AECG心率、心功能、肾功能、Cys-C、NT-proBNP、cTnT比较差异均无统计学意义(P>0.05);治疗后,两组SDNN、rMSSD、SDANN及PNN50、GFR较治疗前升高,LVEDD、LVESD、Scr、BUN、Cys-C、NT-proBNP、cTnT均较治疗前降低(均P<0.05),且Sac/Val组和Val组比较差异有统计学意义(P<0.05);两组不良反应差异无统计学意义(P>0.05)。结论沙库巴曲缬沙坦治疗CRS疗效显著,并可有效改善AECG心率及心肾功能,能降低血清Cys-C、NT-proBNP、cTnT水平。Objective To observe the efficacy of sacubitril/valsartan(Sac/Val)in the treatment of patients with typeⅡcardiorenal syndrome(CRS)and its influence on ambulatory electrocardiogram(AECG)heart rate and levels of serum cystatin-C(Cys-C),N-terminal pro-brain natriuretic peptide(NT-proBNP)and cardiac troponin T(cTnT).Methods 108 patients with typeⅡCRS admitted from August 2021 to August 2023 were selected and classified into 54 cases in Val group(conventional treatment+Val)and 54 cases in Sac/Val group(Sac/Val on the basis of control)by the random number table method.The efficacy after treatment and changes of AECG heart rate[standard deviation of of NN intervals within 24 h(SDNN),percentage of adjacent normal-to-normal interval with standard deviation of≥50 ms(PNN50),root mean square of successive differences(rMSSD),standard deviation of the average normal-to-normal intervals for each of the 5 min segments(SDANN)],cardiac function[left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)]and renal function[glomerular filtration rate(GFR),serum creatinine(Scr),blood urea nitrogen(BUN)]and Cys-C,NT-proBNP and cTnT levels before and after treatment were compared between both groups,and the adverse reactions were recorded.Results The efficacy in Sac/Val group was higher than that in Val group(P<0.05).Before treatment,there were no obvious differences in AECG heart rate,cardiac function,renal function,Cys-C,NT-proBNP and cTnT between the two groups(P>0.05).After treatment,the SDNN,rMSSD,SDANN and PNN50 in both groups were risen compared with those before treatment(P<0.05)while the LVEDD and LVESD were reduced(P<0.05),and the GFR was increased(P<0.05)while the Scr and BUN were enhanced compared to before treatment(P<0.05),and the levels of Cys-C,NT-proBNP and cTnT were lowered in the two groups than those before treatment(P<0.05),and there were obvious differences between Sac/Val group and Val group(P<0.05).The adverse reaction revealed no statistical significance between the two gr

关 键 词：沙库巴曲缬沙坦 心肾综合征 疗效 动态心电图 胱抑素-C 肌钙蛋白T 

分 类 号：R459.7[医药卫生—急诊医学]