沙库巴曲缬沙坦在低收缩压心力衰竭患者中的临床研究

张䶮; 孙冬冬; 范延红

doi:10.12125/j.chj.202105037

沙库巴曲缬沙坦在低收缩压心力衰竭患者中的临床研究

Clinical effect of sacubitril valsartan in treatment of heart failure patients with low systolic blood pressure

摘要

摘要:
目的探究沙库巴曲缬沙坦在低收缩压（90~100） mmHg心力衰竭患者中的耐受剂量、治疗效果和安全性。
方法选取2018年12月~2019年12月就诊于空军军医大学西京医院心内科的心衰患者116例，患者收缩压（90~100）mmHg，随机分为对照组和试验组。对照组在基础治疗上加用缬沙坦，起始剂量20 mg，1次/d；试验组在基础治疗上加用沙库巴曲缬沙坦，起始剂量25 mg，2次/d；接受过ACEI或ARB治疗的患者需停药36 h进行药物洗脱，两组患者治疗开始后每周电话随访血压情况，密切检测不良反应，治疗6个月后评估相关指标。
结果治疗6个月后，沙库巴曲缬沙坦显著改善患者NYHA心功能分级、左室射血分数（LVEF）、N末端B型利钠肽原(NT-proBNP)、6分钟步行距离(6MWD)、明尼苏达心衰量表评分（MHFQL）等指标（均P<0.05）,且改善程度优于对照组（均P<0.05）。两组心血管不良事件和药物相关不良事件发生率无统计学差异。
结论收缩压（90~100）mmHg的心衰患者持续接受沙库巴曲缬沙坦滴定治疗能够显著改善心脏功能和生活质量，且改善程度优于缬沙坦。

Abstract:
AIM To explore the clinical effects of sacubitril valsartan on heat failure with low systolic blood pressure.
METHODS One hundred and sixteen heart failure patients with low systolic blood pressure (90~100) mmHg treated in our Department from December 2018 to December 2019 were randomly divided into a control group and a research group. Based on general treatment, the control group was given an initial dose at 20mg valsartan once a day, while the research group was given an initial dose at 25mg sacubitril valsartan twice a day.
RESULTS After 6 months of treatment, sacubitril valsartan significantly improved the heart function grade of NYHA, left ventricular ejection fraction (LVEF), NT-proBNP, 6 min walking distance (6MWD) and the Minnesota heart failure scale score (MHFQL) compared with those before treatment (P<0.05), and the improvement in the research group was better than that in the control group. There was no significant difference in the incidence of cardiovascular events and drug related events between the two groups.
CONCLUSION The effect of sacubitril valsartan is more significant than valsartan in heart failure patients with low systolic blood pressure (90~100mmHg), which is worthy of additional research and clinical consideration.

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