目的 探讨沙库巴曲缬沙坦钠片治疗血液透析合并射血分数中间值心力衰竭的临床效果。方法 选取2018-12至2021-12在武警内蒙古总队医院血液净化室进行治疗,首次发现射血分数中间值的36例心力衰竭患者为研究对象。随机分为治疗组和对照组,每组18例。两组均进行规律血液透析、利尿剂、β受体阻滞剂治疗。治疗组加用沙库巴曲缬沙坦钠片 50 mg,2次/d;对照组加用缬沙坦胶囊80 mg,1次/d,两组治疗时间均为24周。 24周后对两组的临床疗效、血压和心功能指标进行分析和对比。结果 入院时两组一般临床资料和心脏结构指标无明显差异,24周后治疗组临床有效率为77.8%,明显高于对照组的38.9%,差异有统计学意义(P=0.041),且治疗组心功能改善情况明显优于对照组。治疗组LVEF值明显高于对照组[(50.61±4.27)% vs. (47.50±4.09)%],NT-proBNP明显低于对照组[(3480.89±1308.51)pg/ml vs. (4817.72±1580.41)pg/ml],差异均有统计学意义(P<0.05);两组LVEF、LVEDD、NT-proBNP均较治疗前明显改善(P<0.05),LVPW在治疗前后无明显变化。结论 沙库巴曲缬沙坦钠片能改善血液透析合并射血分数中间值心力衰竭患者心功能,提高LVEF,降低NT-proBNP。
Abstract
Objective To observe the clinical effect of Shakubactril/valsartan sodium tablets on hemodialysis (HD)patients with heart failure with mild-range ejection fraction(HFmrEF). Methods Thirty-six patients with heart failure who received treatment in the Blood purification room of Inner Mongolia Corps Hospital of the Chinese People's Armed Police Force from December 2018 to December 2021 were selected as the research objects, and the HFmrEF was first found. They were randomly divided into treatment group and control group, with 18 cases in each group. Both groups were treated with regular hemodialysis, diuretics and beta blockers. Treatment group was added with salcubactril/valsartan sodium tablets 50 mg, twice a day; The control group was added with 80 mg valsartan capsules once a day, and the treatment time of both groups was 24 weeks. After 24 weeks, the clinical efficacy, blood pressure and cardiac function indexes of the two groups were analyzed and compared. Results There was no significant difference of the clinical data and cardiac parameters between the treatment group and the control group before treatment. After treatment of 24 weeks, the total clinic effective rate[14/18(77.8%)] in the treatment group was significantly higher than that in the control group [7/18(38.9%)] and the improvement of cardiac function in the treatment group was significantly better than that in the control group,while the left ventricular ejection fraction (LVEF) in the treatment group was higher than that in the control group [(50.61±4.27)% vs. (47.50±4.09)%,t=2.232,P=0.032]; N-terminal pro-B-type natriuretic peptide (NT-pro BNP) in the treatment group was significantly lower than that in the control group [(3480.89±1308.51)pg/ml vs. (4817.72±1580.41)pg/ml,t=-2.764,P=0.009], but the cardiac parameters left ventricular end diastolic dimension (LVEDD) and left ventricular posterior wall (LVPW) were no significant difference in the two groups; LVEF, LVEDD, and NT-pro BNP were all improved significantly compared with the baseline in both groups (all P<0.05), and there was no significant difference of LVPW before and after treatment in the two groups. Conclusions Shakubactril/valsartan sodium tablets can improve cardiac function, increase LVEF and decrease NT-proBNP in patients with HFmrEF on hemodialysis.
关键词
沙库巴曲缬沙坦纳片 /
缬沙坦 /
血液透析 /
射血分数中间值心力衰竭
Key words
sacubitril/valsartan /
valsartan /
hemodialysis /
heart failure with mild-range ejection fraction
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基金
武警后勤学院基础研究项目(WHJ201721)
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