沙库巴曲缬沙坦治疗慢性心力衰竭患者的临床疗效研究

目的观察沙库巴曲缬沙坦治疗慢性心力衰竭的临床疗效。方法122例慢性心力衰竭患者随机分为治疗组和对照组,每组各61例。对照组实行常规治疗,治疗组将常规治疗方案中的ACEI/ARB替换为沙库巴曲缬沙坦,比较两组临床疗效、心功能指标[左室射血分数(LVEF)、每博量(SV)、心输出量(CO)、6 min步行距离(6MWT)]、实验室指标[血管紧张素Ⅱ(AngⅡ)、N端脑钠肽前体(NT-proBNP)、肌钙蛋白I(cTnI)]和不良反应。结果治疗组总有效率为91.80%,高于对照组的77.05%(P<0.05)。经治疗后,两组患者心功能指标LVEF、SV、CO、6MWT和实验室指标AngⅡ、ALD、NT-proBNP、cTnI均较治疗前明显改善(P<0.05)。组间相比,治疗组LVEF、SV、CO、6MWT分别为(48.2±4.8)%、(66.7±2.9)ml、(4.8±0.2)L/min和(381.6±23.3)m,均高于对照组的(42.5±3.7)%、(62.3±4.6)ml、(4.5±0.3)L/min和(354.1±18.9)m;AngⅡ、ALD、NTproBNP、cTnI分别为(106.1±13.5)ng/L、(302.3±19.8)pg/ml、(295.5±58.9)pg/ml和(0.11±0.02)ng/ml,均低于对照组的(117.5±17.9)ng/L、(317.6±23.1)pg/ml、(618.7.6±86.4)pg/ml和(0.14±0.02)ng/ml(P<0.05)。两组不良反应发生率相近(P>0.05)。结论本研究显示沙库巴曲缬沙坦治疗慢性心力衰竭安全有效。

Clinical efficacy of sacubitril/valsartan in patients with chronic heart failure

Objective To observe the clinical efficacy of sacubitril/valsartan on chronic heart failure(CHF).Methods CHF patients(n=122)were randomly divided into treatment group and control group(each n=61).The control group was given routine treatment,and treatment group was given sacubitril/valsartan for replacing ACEI/ARB.The clinical efficacy,heart functional indexes[left ventricular ejection fraction(LVEF),stroke volume(SV),cardiac output(CO),6-minute walk distance(6MWD)],laboratory indexes[angiotensin Ⅱ(Ang Ⅱ),N-terminal probrain natriuretic peptide(NT-proBNP)and cardiac troponin I(cTnI)]and adverse reactions were compared between 2 groups.Results The total effective rate was 91.80%in treatment group and 77.05%in control group(P<0.05).After treatment,the heart functional indexes(LVEF,SV,CO,6MWT)and laboratory indexes[AngⅡ,aldosterone(ALD),NT-proBNP,cTnI]were significantly improved in 2 groups(P<0.05).LVEF was(48.2±4.8)%,SV was(66.7±2.9)ml,CO was(4.8±0.2)L/min and 6MWT was(381.6±23.3)m in treatment group,and LVEF was(42.5±3.7)%,SV was(62.3±4.6)ml,CO was(4.5±0.3)L/min and 6MWT was(354.1±18.9)m in control group.AngⅡ was(106.1±13.5)ng/L,ALD was(302.3±19.8)pg/ml,NT-proBNP was(295.5±58.9)pg/ml and cTnI was(0.11±0.02)ng/ml in treatment group,and AngⅡ was(117.5±17.9)ng/L,ALD was(317.6±23.1)pg/ml,NT-proBNP was(618.7.6±86.4)pg/ml and cTnI was(0.14±0.02)ng/ml in control group(P<0.05).The incidence rate of adverse reactions was similar in 2 groups(P>0.05).Conclusion Sacubitril/valsartan is safe and effective in CHF treatment.