沙库巴曲缬沙坦治疗射血分数保留型心力衰竭的临床效果  

Clinical effect of sacubitril valsartan in the treatment of heart failure with preserved ejection fraction

作　　者：梁慧 李雪梦 李志慧 郭学文 程仁力[1] LIANG Hui;LI Xuemeng;LI Zhihui;GUO Xuewen;CHENG Renli(Department of Emergency,Suzhou Hospital of Anhui Medical University,Anhui Province,Suzhou 234000,China)

机构地区：[1]安徽医科大学附属宿州医院急诊科,安徽省宿州市234000 [2]蚌埠医科大学研究生院,安徽省蚌埠市233030

出　　处：《临床合理用药》2025年第8期12-15,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察沙库巴曲缬沙坦治疗射血分数保留型心力衰竭(HFpEF)的临床效果。方法选取2023年12月—2024年3月就诊于安徽医科大学附属宿州医院的HFpEF患者100例,应用随机数字表法分为试验组(n=50)和对照组(n=50)。对照组给予常规对症治疗,试验组在对照组基础上给予沙库巴曲缬沙坦治疗,2组均治疗12周。比较2组临床效果,治疗前后心功能指标[左室射血分数(LVEF)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、二尖瓣环舒张早期和舒张末期血流流速比值(E/A)]、血清学指标[脑利尿钠肽(BNP)、胱抑素C]、运动耐力(6 min步行距离),不良反应。结果试验组总有效率为94.00%,高于对照组的76.00%(χ^(2)=6.353,P=0.012)。治疗12周后,试验组LVEF高于治疗前及同期对照组(P<0.05或P<0.01),对照组LVEF治疗前后比较差异无统计学意义(P>0.05);2组E/A高于治疗前,LVESD、LVEDD小于治疗前,且试验组高/小于对照组(P<0.05或P<0.01);2组BNP、胱抑素C水平低于治疗前,6 min步行距离长于治疗前,且试验组低/长于对照组(P<0.05或P<0.01)。试验组与对照组不良反应总发生率比较差异无统计学意义(8.00%vs.12.00%,χ^(2)=0.444,P=0.505)。结论沙库巴曲缬沙坦治疗HFpEF效果显著,可明显改善心功能,减轻应激反应,提高患者运动耐力,且安全性高。Objective To observe the clinical effect of sacubitril valsartan in the treatment of heart failure with preserved ejection fraction(HFpEF).Methods A total of 100 HFpEF patients admitted to Suzhou Hospital of Anhui Medical University from December 2023 to March 2024 were selected and divided into experimental group(n=50)and control group(n=50)by random number table method.The control group was given conventional symptomatic treatment,and the experimental group was given sacubitril valsartan treatment on the basis of the control group.Both groups were treated for 12 weeks.The clinical effects,cardiac function indicators(LVEF,LVESD,LVEDD,E/A),serological indicators(BNP,cystatin C),exercise endurance(6 min walking distance)before and after treatment,and adverse reactions were compared between two groups.Results The total effective rate of the experimental group was 94.00%,which was higher than 76.00%of the control group(χ^(2)=6.353,P=0.012).After 12 weeks of treatment,LVEF of experimental group was higher than that before treatment and control group(P<0.05 or P<0.01),and there was no statistical significance in LVEF of control group before and after treatment(P>0.05).E/A in two groups were higher than before treatment,LVESD and LVEDD were lower than before treatment,and the experimental group were higher/lower than control group(P<0.05 or P<0.01).The levels of BNP and cystatin C were lower than before treatment,the 6-min walking distance were longer than before treatment in two groups,and the experimental group were lower/longer than the control group(P<0.05 or P<0.01).There was no significant difference in the total incidence of adverse reactions between the experimental group and the control group(8.00%vs.12.00%,χ^(2)=0.444,P=0.505).Conclusion Sacubitril valsartan has a significant effect in the treatment of HFpEF,which can significantly improve cardiac function,reduce stress response,improve exercise endurance of patients,and has high safety.

关 键 词：射血分数保留型心力衰竭 沙库巴曲缬沙坦 心功能 安全性 

分 类 号：R541.6[医药卫生—心血管疾病]