沙库巴曲缬沙坦联合磷酸肌酸钠治疗射血分数降低型心力衰竭的疗效观察  

Effect of sacubitril/valsartan combined with creatine phosphate sodium in treatment of patients with heart failure with reduced ejection fraction

作　　者：董少元 屈艳玲 王蕾[1] 刘达瑾[2] DONG Shaoyuan;QU Yanling;WANG Lei;LIU Dajin(Department of Cardiovascular Medicine,Yuncheng Central Hospital Affiliated to Shanxi Medical University,Yuncheng,Shanxi,044000;Department of Cardiology,the First Hospital of Shanxi Medical University,Taiyuan,Shanxi,030000)

机构地区：[1]山西医科大学附属运城市中心医院心血管内科,山西运城044000 [2]山西医科大学第一医院心血管内科,山西太原030000

出　　处：《实用临床医药杂志》2025年第5期40-44,共5页Journal of Clinical Medicine in Practice

基　　金：山西省科学技术研究与开发项目(202200D093187)。

摘　　要：目的探讨沙库巴曲缬沙坦联合磷酸肌酸钠治疗射血分数降低型心力衰竭(HFrEF)患者的临床疗效。方法将116例HFrEF患者随机分为联合组和对照组,每组58例。对照组采用沙库巴曲缬沙坦治疗,联合组采用沙库巴曲缬沙坦联合磷酸肌酸钠治疗,2组均连续治疗8周。比较2组临床疗效,治疗前和治疗4、8周氧化应激指标、心功能指标、血管内皮功能指标、心肌损伤指标,以及不良反应发生情况。结果联合组总有效率为94.83%,高于对照组的81.03%,差异有统计学意义(P<0.05)。治疗4、8周时,联合组左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)低于对照组,左心室射血分数(LVEF)高于对照组,差异均有统计学意义(P<0.01);联合组血栓素2(TVB2)、内皮素-1(ET-1)低于对照组,血管内皮生长因子(VEGF)高于对照组,差异均有统计学意义(P<0.01);联合组心肌肌钙蛋白I(cTnI)、心型脂肪酸结合蛋白(H-FABP)、氨基酸末端B型脑钠肽前体(NT-proBNP)低于对照组,差异有统计学意义(P<0.01)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论沙库巴曲缬沙坦联合磷酸肌酸钠治疗HFrEF疗效确切,可调节患者氧化应激程度,改善血管内皮功能,进而促进患者心功能恢复。Objective To explore the clinical efficacy of sacubitril/valsartan combined with creatine phosphate sodium in heart failure patients with reduced ejection fraction(HFrEF).Methods A total of 116 patients with HFrEF were randomly divided into combination group and control group,with 58 cases in each group.The control group was treated with sacubitril/valsartan,while the combination group was treated with sacubitril/valsartan and creatine phosphate sodium.Both groups were continually treated for 8 weeks.The clinical efficacy,oxidative stress indicators,cardiac function indicators,vascular endothelial function indicators and myocardial injury indicators before treatment and at 4 and 8 weeks after treatment as well as the occurrence of adverse reactions were compared between the two groups.Results The total effective rate was 94.83% in the combination group,which was significantly higher than 81.03% in the control group(P<0.05).At 4 and 8 weeks of treatment,the left ventricular end-systolic diameter(LVESD)and left ventricular end-diastolic diameter(LVEDD)in the combination group were significantly lower than those in the control group,while the left ventricular ejection fraction(LVEF)was significantly higher than that in the control group(P<0.01);the thromboxane B2(TXB2)and endothelin-1(ET-1)levels in the combination group were significantly lower than those in the control group,while the vascular endothelial growth factor(VEGF)level was significantly higher than that in the control group(P<0.01);the levels of cardiac troponin I(cTnI),heart-type fatty acid-binding protein(H-FABP)and N-terminal pro-brain natriuretic peptide(NT-proBNP)in the combination group were significantly lower than those in the control group(P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Sacubitril/valsartan combined with creatine phosphate sodium has a definite therapeutic effect in treating patients with HFrEF,which can regulate the degree of oxidative stress,improve v

关 键 词：射血分数降低型心力衰竭 沙库巴曲缬沙坦 磷酸肌酸钠 氧化应激 血管内皮功能 心功能指标 不良反应 心肌肌钙蛋白 

分 类 号：R972[医药卫生—药品] R541.6[医药卫生—药学] R331.3