沙库巴曲缬沙坦对老年1型心肾综合征患者的临床疗效

目的:观察沙库巴曲缬沙坦对老年1型心肾综合征(CRS-1)患者的临床疗效.方法:选取某院2017年9月-2020年9月收治的老年急性失代偿性心力衰竭(ADHF)引起的急性肾损伤(AKI)患者,即CRS-1患者98例为研究对象,随机分为对照组和治疗组各49例.治疗组在常规治疗的同时应用沙库巴曲缬沙坦钠片(ARNI),对照...

Clinical efficacy of sacubitril-valsartan on elderly patients with type 1 cardiorenal syndrome

OBJECTIVE To observe the clinical efficacy of sacubitril-valsartan on elderly patients with type 1 cardiorenal syndrome (CRS-1).METHODS From September 2017 to September 2020, 98 patients with acute kidney injury (AKI) due to acute decompensated heart failure (ADHF), also known as type 1 cardiorenal syndrome (CRS-1), were selected as study subjects. They were randomly divided into control and treatment groups (n=49 each). Both groups received general medications for ADHF. In addition, treatment group had sacubitril-valsartan tablets (ARNI) while control group angiotensin converting enzyme inhibitors/angiotensin receptor inhibitors (ACEI/ARB). After 4-week treatment, the levels of serum creatinine (Scr) N-terminal pro-brain peptide (NT-proBNP), hypersensitive C-reactive protein (hs-CRP), left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD) and six-minute walk test distance (6MWTD) were compared between 2 groups. Also the therapeutic efficacy of ADHF and adverse reactions were observed.RESULTS The pre-treatment levels of SCr, NT-proBNP, hs-CRP, LVEF, LVEDD and 6MWTD showed no statistical inter-group difference (P>0.05). And the post-treatment levels of SCr, NT-proBNP, hs-CRP and LVEDD declined (P<0.05) while the levels of LVEF and 6MWTD increased in both groups. And there were inter-group differences (P<0.05). The overall effective rate of ADHF was 91.8% and 77.5% in treatment and control groups respectively. Treatment group was significantly better than control group (P=0.049). The incidence of adverse reactions showed no inter-group differences (P=0.564).CONCLUSION Shakuba-trivalsartan is both safe and efficacious for elderly patients with CRS-1. It can significantly improve cardiorenal functions and wider popularization is worthy.