摘要
目的观察沙库巴曲缬沙坦在不同病因所致的慢性心力衰竭患者治疗后的临床效果。方法选取蚌埠医学院第一附属医院2018年1月~2019年4月收治的74例左心室射血分数(LVEF)≤40%的慢性心力衰竭患者作为研究对象,依据心功能分级将其分为Ⅱ级亚组(7例),Ⅲ级亚组(33例),Ⅳ级亚组(34例);依据病因将其分为冠心病亚组(42例),高血压性心脏病亚组(7例),扩张型心肌病亚组(25例)。所有患者常规抗心衰治疗,将血管紧张素转化酶抑制剂(ACEI)/血管紧张素Ⅱ受体拮抗剂(ARB)替换为沙库巴曲缬沙坦,标准化治疗连续3个月。观察不同患者临床疗效,比较治疗前后各腔室及心功能指标,记录心血管终点事件发生情况。结果不同心功能分级亚组及不同病因亚组临床有效率比较,差异无统计学意义(P>0.05)。不同心功能分级亚组及不同病因亚组治疗前后各腔室及LVEF比较,差异均无统计学意义(均P>0.05);与治疗前比较,Ⅱ~Ⅳ级亚组治疗后左室舒张末期内径(LVd)明显缩小,LVEF明显提高,差异均有统计学意义(P<0.05)。高心病亚组、冠心病亚组、扩心病亚组治疗后LVd小于治疗前,LVEF高于治疗前,差异均有统计学意义(均P<0.05)。心血管终点事件发生率为9.45%。结论沙库巴曲缬沙坦可明显改善慢性心力衰竭患者的心功能,且对不同病因及不同心功能分级所致的心力衰竭患者临床效果基本相同。
Objective To observe the clinical effect of Sacubitril/Valsartan in the treatment of patients with chronic heart failure caused by different etiologies.Methods Seventy-four cases with chronic heart failure of left ventricular ejection fraction(LVEF)≤40%who admitted to the First Affiliated Hospital of Bengbu Medical College from January 2018 to April 2019 were selected as the study objects.According to cardiac function grade,they were divided intoⅡgrade subgroups(7 cases),Ⅲgrade group(33 cases),Ⅳgrade subgroups(34 cases).According to the etiology,they were divided into coronary heart disease subgroup(42 cases),hypertensive heart disease subgroup(7 cases),dilated cardiomyopathy subgroup(25 cases).All patients were routine anti-heart failure treatment,and angiotensin converting enzyme inhibitor(ACEI)/angiotensinⅡreceptor antagonist(ARB)were replaced by Sacubitril/Valsartan.Qualitative treatment lasted for 3 months.The clinical efficacy of different patients were observed.The indexes of ventricular and cardiac function before and after treatment were compared,and the incidence of cardiovascular end-point events were recorded.Results There was no significant difference in clinical efficacy rate in different etiological subgroups and different cardiac function grades subgroups(P>0.05).There was no significant difference in ventricular and LVEF of different cardiac function grades subgroups and different etiological subgroups before and after treatment(P>0.05).Compared with before treatment,left ventricular end-diastolic diameter(LVd)significantly reduced,LVEF increased significantly after treatment inⅡ-Ⅳgrade subgroups,and the differences were statistical significance(all P<0.05);LVd significantly reduced,LVEF increased significantly in after treatment coronary heart disease subgroup,hypertensive heart disease subgroup and dilated cardiomyopathy subgroup,and the differences were statistical significance(all P<0.05).The incidence of cardiovascular end-point events was 9.45%.Conclusion Sacubitril/Valsartan can significantly improve the cardiac function of patients with chronic heart failure,and the clinical efficacy of patients with heart failure caused by different etiology and cardiac function grade is basically the same.
作者
唐碧
朱磊
朱明利
谢彩侠
徐庆梅
康品方
宣玲
张恒
TANG Bi;ZHU Lei;ZHU Mingli;XIE Caixia;XU Qingmei;KANG Pinfang;XUAN Ling;ZHANG Heng(Department of Cardiovascular,the First Affiliated Hospital of Bengbu Medical College,Anhui Province,Bengbu233004,China)
出处
《中国医药导报》
CAS
2020年第7期160-163,共4页
China Medical Herald
基金
安徽省高校自然科学研究项目(KJ2017B254)。
关键词
沙库巴曲缬沙坦
慢性心力衰竭
心功能
临床效果
Sacubitril/Valsartan
Chronic heart failure
Cardiac function
Clinical effect
作者简介
唐碧(1975.10-),男,博士,副主任医师,副教授,主要从事冠心病基础与临床研究;通讯作者:张恒(1963.5-),男,硕士,主任医师,副教授,研究方向:冠心病基础与临床。
