沙库巴曲缬沙坦钠片联合百令胶囊治疗慢性左心衰竭合并肾功能不全的临床观察

目的:研究沙库巴曲缬沙坦钠片联合百令胶囊治疗慢性左心衰竭合并肾功能不全患者的疗效及安全性,为临床用药提供参考.方法:将2018年11月至2019年11月于四川省人民医院就诊的96例慢性左心衰竭合并肾功能不全患者根据随机数字表法分为A、B、C组,每组32例.A组患者给予常规抗心力衰竭治疗和百令胶囊(每次2 g,每日3次)...

Clinical Observation of Sacubitril Valsartan Sodium Tablets Combined with Bailing Capsules in the Treatment of Chronic Left Heart Failure with Renal Insufficiency

OBJECTIVE:To study the efficacy and safety of sacubitril valsartan sodium tablets combined with Bailing capsules in the treatment of chronic left heart failure with renal insufficiency,and to provide reference for clinical drug use.METHODS:Totally 96 patients with chronic left heart failure with renal insufficiency who sought medical care in our hospital from Nov.2018 to Nov.2019 were divided into group A,B and C according to table of random numbers,with 32 cases in each group.Group A received conventional heart failure treatment and and Bailing capsules(2 g each time,3 times a day);group B received conventional heart failure treatment and Sacubitril valsartan sodium tablets(50 mg each time,twice a day);group C was given with heart failure treatment and Sacubitril valsartan sodium tablets(50 mg each time,twice a day)and Bailing capsules(2 g each time,3 times a day).3 groups received consecutive 6 months of treatment.Clinical response rates of 3 groups were compared.Left heart function indexes[left ventricular end systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)]and serological indexes[interleukin 1(IL-1),IL-6,N terminal brain natriuretic peptide precursor,glomerular filtration rate(GFR)]were detected before and after treatment.The occurrence of ADR were observed and recorded.RESULTS:During this study,a total of 6 patients fell off,and eventually 90 patients completed the study,including 29 cases in group A,30 cases in group B and 31 cases in group C.Before treatment,there was no statistical significance in left heart function indexes or serological indexes among 3 groups(P>0.05).After 6 months of treatment,clinical response rate of group C was significantly higher than those of group A and B(P<0.05).Compared with before treatment,LVEDD,LVESD and serological indexes of 3 groups were decreased significantly after treatment(P<0.05),while LVEF and GFRwere increased significantly(P<0.05);the changes of above indexes(except for IL-1 level in serum)in group C were significantly better than group A and B,the changes of above indexes in group B(except for GFR)were significantly better than group A(P<0.05).No significant ADR were observed in 3 groups.CONCLUSIONS:Sacubitril valsartan sodium tablets combined with Bailing capsules can significantly decrease the level of serum inflammation factors,and improve cardiac and renal function in patients with chronic left heart failure with renal insufficiency,with good safety.