文和, 邱继欢, 胡朗, 亓秉超, 李春雨, 陶凌, 李妍. 沙库巴曲缬沙坦治疗射血分数中间值心力衰竭患者的临床疗效[J]. 心脏杂志, 2020, 32(2): 135-139. DOI: 10.12125/j.chj.202002064
    引用本文: 文和, 邱继欢, 胡朗, 亓秉超, 李春雨, 陶凌, 李妍. 沙库巴曲缬沙坦治疗射血分数中间值心力衰竭患者的临床疗效[J]. 心脏杂志, 2020, 32(2): 135-139. DOI: 10.12125/j.chj.202002064
    He WEN, Ji-huan QIU, Lang HU, Bing-chao QI, Chun-yu LI, Ling TAO, Yan LI. Clinical effect of sacubitril valsartan in treating heart failure patients with mid-range ejection fraction[J]. Chinese Heart Journal, 2020, 32(2): 135-139. DOI: 10.12125/j.chj.202002064
    Citation: He WEN, Ji-huan QIU, Lang HU, Bing-chao QI, Chun-yu LI, Ling TAO, Yan LI. Clinical effect of sacubitril valsartan in treating heart failure patients with mid-range ejection fraction[J]. Chinese Heart Journal, 2020, 32(2): 135-139. DOI: 10.12125/j.chj.202002064

    沙库巴曲缬沙坦治疗射血分数中间值心力衰竭患者的临床疗效

    Clinical effect of sacubitril valsartan in treating heart failure patients with mid-range ejection fraction

    • 摘要:
        目的  探究沙库巴曲缬沙坦对射血分数中间值心力衰竭患者治疗的临床效果。
        方法  选取2018年12月~2019年6月于空军军医大学西京医院心内科就诊的82例射血分数中间值心衰(HFmrEF)患者作为研究对象,随机分为对照组和试药组,每组41例。在一般治疗的基础上,对照组加用80 mg缬沙坦口服,每天2次,试药组加用100 mg沙库巴曲缬沙坦口服,每天2次。比较两组患者的治疗效果和不良事件发生率。
        结果  治疗前,两组患者基线资料均不存在统计学差异;治疗后,与对照组相比,试药组患者的治疗有效率显著提高,(P<0.05);与本组治疗前相比,两组左室射血分数(LVEF)水平、左室整体纵向应变 (LVGLS)和左室短轴缩短率(FS)水平存在显著性差异(均P<0.05),治疗后LVGLS水平试药组患者明显高于对照组,且存在统计学差异 (P<0.05);与同组治疗前相比,两组患者心衰相关标志物生长转化因子(GDF)-15、可溶性肿瘤因子2抑制剂(sST2)水平和氨基末端脑钠尿肽前体(NT-proBNP)浓度均存在显著性差异(均P <0.05),治疗后GDF-15和NT-proBNP试药组较对照组患者相比改善更明显,具有统计学意义(均P<0.05);与同组治疗前相比,两组患者6分钟步行距离(6MWD)和明尼苏达心衰量表评分(MHFQL)均有显著差异(均P<0.05),治疗后6MWD试药组较对照组变化不明显,不具有统计学差异,MHFQL试药组较对照组显著降低,具有统计学意义(P<0.05);两组心血管事件发生率和再住院率、死亡率没有显统计学异。
        结论  对HFmrEF患者的心功能治疗方面,沙库巴曲缬沙坦较缬沙坦作用效果更显著,且心血管事件发生率和再住院率、病死率没有显著差异,值得临床上研究应用。

       

      Abstract:
        AIM  To explore the clinical effects of sacubitril valsartan on heart failure patients with mid-range ejection fraction.
        METHODS  Eighty-two patients with heart failure with mid-range ejection fraction (HFmrEF), who were treated in the Department of Cardiology, Xijing Hospital, Air Force Medical University from December 2018 to June 2019, were randomly divided into a control group and a research group, 41 cases in each group. Based on general treatment, the control group was given 80 mg valsartan orally twice a day, while the research group was given 100 mg sacubitril valsartan orally twice a day. The therapeutic effects and the incidence of adverse events of the two groups were compared.
        RESULTS  Before treatment, there was no statistical difference in baseline data between two groups. After treatment, compared with the control group, the treatment effective rate of patients in research group was significantly enhanced with statistical significance (P < 0.05). Compared with those before treatment, there were significant differences in left ventricular ejection fraction (LVEF), left ventricular overall longitudinal strain (LVGLS) and left ventricular short axis shortening rate (FS) in both groups (P < 0.05). After treatment, LVGLS in the research group was higher than that in control group, with statistical significance (P < 0.05). The levels of GDF-15, sST2 and NT-proBNP in heart failure related markers were significantly different from those before treatment in the same group (P < 0.05) and the improvement of GDF-15 and NT-proBNP in the research group was more obvious than that in the control group (P < 0.05). Compared with those before treatment, there were significant differences in the 6 min walking distance (6MWD) and the Minnesota heart failure scale score (MHFQL) in both groups (P < 0.05). After treatment, there was no significant difference in the 6MWD between the two groups. The MHFQL in research group was significantly lower than that in control group, with statistical significance (P < 0.05). There was no significant difference in the incidence of cardiovascular events, readmission rate and mortality rate between the two groups.
        CONCLUSION  With no significant difference in the incidence rate of cardiovascular events, readmission rate and mortality rate, the effect of sacubitril valsartan is more significant than valsartan for treatment of cardiac functions in patients with heart failure with mid-range ejection fraction, which is worthy of additional research and clinical consideration.

       

    /

    返回文章
    返回