| 涂克祥,王岳松,邵旭武,等.沙库巴曲缬沙坦在急性失代偿性心力衰竭病人的临床应用[J].安徽医药,2021,25(3):611-613. |
| 沙库巴曲缬沙坦在急性失代偿性心力衰竭病人的临床应用 |
| Clinical application of sacubitril/valsartan in patients with acute decompensated heart failure |
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| DOI：10.3969/j.issn.1009-6469.2021.03.045 |
| 中文关键词: 心力衰竭 沙库巴曲 缬沙坦 每搏输出量 利钠肽，脑 临床疗效 再住院率 |
| 英文关键词: Heart failure Sacubitril Valsartan Stroke volume Natriuretic peptide, brain Clinical curative effect Rehos? pitalization |
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| 中文摘要: |
| 目的探讨沙库巴曲缬沙坦在急性失代偿性心力衰竭病人的临床疗效。方法选取 2019年 1—6月在马鞍山市人民医院住院治疗的急性失代偿性心力衰竭病人 115例，血流动力学稳定后根据随机数字表法分为观察组 57例和对照组 58例。常规心衰治疗基础上观察组予以沙库巴曲缬沙坦口服，对照组予以血管紧张素转换酶抑制剂( ACEI)/血管紧张素 Ⅱ受体拮抗剂( ARB)口服。两组病人均连续治疗 4个月，比较两组病人治疗前后在左室射血分数( LVEF)、左心室舒张末期内径(LVEDd)、 N末端脑钠肽前体( NT-proBNP)值、 6 min步行试验、再住院率、药物不良反应等指标的差异。结果两组病人左室射血分数均较治疗前改善，观察组优于对照组( P= 0.004)；两组病人 6 min步行试验均较治疗前好转，观察组优于对照组( P<0.001)；两组病人治疗期间 NT-proBNP均较前下降，观察组下降幅度更大( P = 0.027)；观察组再住院率( 8.9%，5/56)低于对照组(26.3%，15/57)(P = 0.030)；两组病人 LVEDd均较治疗前改善( P < 0.001)两组间差异无统计学意义(P = 0.550)。两组病人均未出现症状性低血压、咳嗽、血管性水肿及高钾血症等，观察组和对照组治疗期间均出现 1例病人死亡。结论沙库巴曲病人，缬沙坦能显著改善心力衰竭病人射血分数及运动耐量，减少病人住院次数，且安全性较高。 |
| 英文摘要: |
| Objective To investigate the clinical effect of sacubitril/valsartan in patients with acute decompensated heart failure. Methods From January to June 2019,a total of 115 patients with acute decompensated heart failure were selected from MaanshanPeople′s Hospital. After hemodynamic stabilization, patients were randomized to observation group (n=57) and control group (n=58). Pa?tients in observation group received sacubitril/ valsartan, while control group received ACEI/ARB. Both groups undertook continuoustreatment for 4 months. The changes of left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDd), N-ter? minal pro-B-type natriuretic peptide (NT-proBNP), 6 -minute walk test distance, rehospitalization and adverse drug reactions were com? pared after treatment. Results LVEF, LVEDd and the 6 -minute walk test distance were improved compared with those before treat?ment in both groups. LVEF in the observation group was superior to that in the control group (P = 0.004); the 6 -minute walk test dis? tance in the observation group was statistically significantly better than that in the control group (P < 0.001); NT-proBNP in observation group decreased more than that in control group (P = 0.027); The hospital readmission rate of in the observation group (8.9%, 5/56) was lower than that (26.3%, 15/57) in the control group (P = 0.030); No statistically significant differences of LVEDd were found after treat? ment between the two groups (P = 0.550). The symptomatic hypotension, angioedema, irritating cough and hyperkalemia did not differsignificantly between the two groups. One patient died during the treatment in the observation group and 1 patient died in the controlgroup. Conclusion Sacubitril/valsartan can significantly improve ejection fraction and activity tolerance in patients with acute decom?pensated heart failure, reduce the rate of rehospitalization, with relatively high safety. |
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