沙库巴曲缬沙坦钠与培哚普利治疗慢性射血分数减少心力衰竭的疗效观察

目的研究沙库巴曲缬沙坦钠(ARNI)与培哚普利治疗慢性射血分数减少心力衰竭(HFrEF)患者的疗效。方法 80例HFrEF患者,采用随机数字表法分为观察组和对照组,每组40例。对照组采用培哚普利治疗,观察组采用沙库巴曲缬沙坦钠治疗。观察比较两组患者治疗前后左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、N-末端B型利钠肽(NT-proBNP)水平,治疗效果,不良反应发生情况。结果观察组总有效率为95.0%,明显高于对照组的77.5%,差异有统计学意义(P<0.05)。治疗前,两组LVEDD、LVEF、NT-proBNP水平比较,差异无统计学意义(P>0.05);治疗后,观察组LVEDD(50.10±5.62)mm、NT-proBNP(110.68±75.28)pg/ml均低于对照组的(55.17±6.55)mm、(320.56±68.58)pg/ml, LVEF(50.28±7.20)%高于对照组的(44.62±5.23)%,差异均有统计学意义(P<0.05)。观察组不良反应发生率为30.0%,低于对照组的52.5%,差异有统计学意义(P<0.05)。结论沙库巴曲缬沙坦钠在改善HFrEF患者LVEF、LVEDD及NT-proBNP水平方面效果明显优于培哚普利,且未发现其他明显不良反应。

Efficacy observation on sacubitril/valsartan and perindopril in the treatment of chronic heart failure with reduced ejection fraction

Objective To study the efficacy of sacubitril/valsartan(ARNI) and perindopril in the treatment of patients with chronic heart failure with reduced ejection fraction(HFrEF). Methods A total of 80 HFrEF patients were divided into observation group and control group by random number table method, with 40 cases in each group. The control group was treated by perindopril, and the observation group was treated by sacubitril/valsartan. The left ventricular ejection fraction(LVEF), left ventricular end diastolic diameter(LVEDD), N-terminal pro-B-type natriuretic peptide(NT-proBNP) levels before and after treatment, therapeutic effect and occurrence of adverse reactions were observed and compared between the two groups. Results The total effective rate 95.0% in the observation group was obviously higher than 77.5% in the control group, and the difference was statistically significant(P<0.05). Before treatment, there was no statistically significant difference in LVEDD, LVEF and NT-proBNP between the two groups(P>0.05). After treatment, the LVEDD(50.10±5.62) mm and NT-proBNP(110.68±75.28) pg/ml in the observation group were lower than(55.17±6.55) mm and(320.56±68.58) pg/ml in the control group, and LVEF(50.28±7.20)% was higher than(44.62±5.23)% in the control group. Their difference was statistically significant(P<0.05). The total incidence of adverse reactions was 30.0% in the observation group, which was lower than 52.5% in the control group, and the difference was statistically significant(P<0.05). Conclusion Sacubitril/valsartan is significantly better than perindopril in improving cardiac function, LVEF, LVEDD, and NT-proBNP in patients with HfrEF. No other significant adverse reactions are found.