| 沙库巴曲缬沙坦对维持性血液透析患者慢性充血性心力衰竭的影响 |
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| 引用本文： | 赵莹晖 孙艺郑华,史高悦. 沙库巴曲缬沙坦对维持性血液透析患者慢性充血性心力衰竭的影响[J]. 国际医药卫生导报, 2022, 28(14): 1940-1944. DOI: 10.3760/cma.j.issn.1007-1245.2022.14.004 |
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| 作者姓名： | 赵莹晖 孙艺郑华 史高悦 |
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| 作者单位： | 沈阳医学院附属中心医院肾内科,沈阳 110000 |
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| 基金项目： | 辽宁省科学技术计划项目（2019-ZD-0328） |
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| 摘 要： | 目的 探究沙库巴曲缬沙坦对维持性血液透析患者慢性充血性心力衰竭的影响。方法 选取2020年1月至2021年1月在沈阳医学院附属中心医院行维持性血液净化,美国纽约心脏病协会（NYHA）心功能分级Ⅲ～Ⅳ级患者60例,按随机数字表法分为研究组和对照组各30例。研究组男21例,女9例,年龄（63.5±11.9）岁;对照组男15例,女15例,年龄（61.9±11.3）岁。两组患者均经同一医生评估达到干体重,研究组在常规治疗的基础上加用沙库巴曲缬沙坦,对照组在常规治疗的基础上加用缬沙坦。3个月后,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）、N末端前体脑利钠肽（NT-proBNP）、6 min步行试验距离（6MWT）、血肌酐（Scr）、尿素氮（BUN）、白蛋白、血清钾和血压变化,并评估心功能（以上数据采集均在透析前进行）。计量资料采用t检验,计数资料采用χ2检验或Fisher确切概率法。结果 治疗前,两组LVEF、LVEDD、NT-proBNP、6MWT、Scr、BUN、白蛋白、血清钾和血压水平差异均无统计学意义（均P>0.05）。治疗后,研究组总有效率显著高于对照组［96.7%（29/30）比73.3%（22/30）］,两组LVEF、LVEDD、NT-proBNP、6MWT、血压均优于治疗前,且研究组相比于对照组LVEDD、NT-proBNP、血压显著降低,LVEF、6MWT显著增加,两组指标对比差异均有统计学意义（均P<0.05）。两组Scr、BUN、白蛋白、血清钾无明显改变,差异均无统计学意义（均P>0.05）。结论 沙库巴曲缬沙坦能有效改善维持性血液透析患者慢性充血性心力衰竭,显著降低动脉血压,血钾无明显升高,Scr、BUN、白蛋白无明显变化。
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| 关 键 词： | 沙库巴曲缬沙坦 尿毒症 血液透析 慢性充血性心力衰竭 |
| 收稿时间： | 2021-12-02 |
Effect of sacubitril/valsartan on chronic congestive heart failure inmaintenance hemodialysis patients |
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| Zhao Yinghui,Sun Yi,Zheng Hua,Shi Gaoyue. Effect of sacubitril/valsartan on chronic congestive heart failure inmaintenance hemodialysis patients[J]. International Medicine & Health Guidance News, 2022, 28(14): 1940-1944. DOI: 10.3760/cma.j.issn.1007-1245.2022.14.004 |
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| Authors: | Zhao Yinghui Sun Yi Zheng Hua Shi Gaoyue |
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| Affiliation: | Department of Nephrology, Affiliated Central Hospital of ShenyangMedical College, Shenyang 110000, China |
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| Abstract: | Objective To investigate the effect of sacubitril/valsartan on chronic congestiveheart failure in maintenance hemodialysis patients. Methods A total of 60 patients with New York Heart Association (NYHA) cardiacfunction classification Ⅲ-Ⅳ who underwent maintenance blood purification inAffiliated Central Hospital of Shenyang Medical College from January 2020 toJanuary 2021 were selected and were divided into a study group and a controlgroup according to the random number table method, with 30 cases in each group.The study group included 21 males and 9 females, aged (63.5±11.9) years; thecontrol group included 15 males and 15 females, aged (61.9±11.3) years. Bothgroups were assessed by the same physician to achieve dryweight. The study group was treated with sacubitril/valsartan on thebasis of routine treatment, and the control group was treated with valsartan onthe basis of routine treatment. Three months later, the changes of leftventricular ejection fraction (LVEF), left ventricular end-diastolic diameter(LVEDD), N-terminal pro-brain natriuretic peptide (NT-probNP), 6-min walkingtest distance (6MWT), serum creatinine (Scr), urea nitrogen (BUN), albumin,serum potassium, and blood pressure in the two groups before and aftertreatment were compared, and the cardiac function was assessed (all the abovedata were collected before dialysis). t test was used for the measurement data and χ2 test or Fisher's exact probability method was used for the count data. Results Before treatment, there were no statisticallysignificant differences in the LVEF, LVEDD, NT-proBNP, 6MWT, Scr, BUN, albumin,serum potassium, and blood pressure between the two groups (all P>0.05). After treatment, the totaleffective rate of the study group was significantly higher than that of thecontrol group [96.7% (29/30) vs. 73.3% (22/30)]; the LVEF, LVEDD, NT-proBNP,6MWT, and blood pressure in both groups were better than those beforetreatment; compared with those in the control group, the LVEDD, NT-proBNP, andblood pressure in the study group were significantly reduced, while the LVEFand 6MWT were significantly increased; there were statistically significantdifferences between the two groups (all P<0.05).There were no significant changes in the Scr, BUN, albumin, and serum potassiumbetween the two groups (all P>0.05). Conclusions Sacubitril/valsartancan effectively improve chronic congestive heart failure in maintenancehemodialysis patients, and significantly reduce the arterial blood pressure, atthe same time, there is no significant increase in serum potassium, and nosignificant change in Scr, BUN, or albumin. |
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| Keywords: | Sacubitril/valsartan Uremia Hemodialysis Chronic congestiveheart failure |
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