沙库巴曲缬沙坦对扩张型心肌病伴射血分数中间范围心力衰竭的疗效研究  

The efficacy of sacubitril valsartan in the treatment of heart failure with mid-range ejection fraction in dilated cardiomyopathy patients

作　　者：李超[1] 陈云 余晗俏 盛晓生[1] LI Chao;CHEN Yun;YU Hanqiao;SHENG Xiaosheng(Department of Cardiology,Jinhua People's Hospital,Jinhua 321000,China)

机构地区：[1]金华市人民医院心内科,321000

出　　处：《心电与循环》2025年第1期21-24,30,共5页Journal of Electrocardiology and Circulation

基　　金：金华市科学技术局公益项目(2021-3-117)。

摘　　要：目的探讨扩张型心肌病(DCM)伴射血分数中间范围心力衰竭(HFmrEF)患者使用沙库巴曲缬沙坦的疗效。方法前瞻性选择2021年1月至2022年12月金华市人民医院收治的DCM伴HFmrEF患者74例,采用随机数字表法分为观察组和对照组,每组37例,观察组采用沙库巴曲缬沙坦,对照组采用依那普利治疗。比较两组患者治疗前后左心室射血分数(LVEF)、左心室舒张末期内径(LVEDd)、6 min步行距离(6MWD)、高迁移率族蛋白B1(HMGB1)、N末端脑钠肽前体(NT-proBNP)、半乳糖凝集素3(Gal-3)水平,观察治疗期间不良反应和1年内心力衰竭再住院率、全因死亡率。结果两组患者治疗前上述观察参数组比较,差异无统计学意义(均P>0.05)。治疗1年后,观察组LVEF、6MWD高于对照组,LVEDd、HMGB1、NT-proBNP、Gal-3及心力衰竭再住院率低于对照组,差异均有统计学意义(均P<0.05)。两组患者症状性低血压、干咳、高钾血症及全因死亡发生率比较,差异均无统计学意义(均P>0.05)。结论沙库巴曲缬沙坦可改善DCM伴HFmrEF患者的心脏功能。Objective To investigate the efficacy of sacubitril valsartan in patients with dilated cardiomyopathy(DCM)and heart failure with mid-range ejection fraction(HFmrEF).Methods Seventy-four patients with DCM and HFmrEF treated in Jinhua People's Hospital from January 2021 to December 2022 were enrolled.They were randomly divided into observation group(n=37,treated with sacubitril valsartan)and control group(n=37,treated with enalapril).Left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDd),six-minute walk distance(6MWD),high mobility group box 1 protein(HMGB1),N-terminal pro-brain natriuretic peptide(NT-proBNP),and galectin-3(Gal-3)were compared between the two groups before and after treatment.The adverse reactions during treatment,heart failure rehospitalization rate and all-cause mortality within 1 year were observed.Results The observation parameters were not significantly different between the two groups before treatment(all P>0.05).After 1 year of treatment,LVEF and 6MWD were significantly higher,while LVEDd,HMGB1,NT-proBNP,Gal-3 and readmission rate were significantly lower in the observation group than in the control group(all P<0.05).There was no statistical significance in the incidence of symptomatic hypotension,dry cough and hyperkalemia and all-cause mortality between the two groups(all P>0.05).Conclusion Sacubitril valsartan can improve cardiac function in patients with DCM and HFmrEF.

关 键 词：心力衰竭 沙库巴曲缬沙坦 扩张型心肌病 心肌重构 

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