摘要
目的分析血管紧张素受体脑啡肽酶抑制剂(ARNI)对心力衰竭患者心功能及B型利钠肽(BNP)、一氧化氮(NO)表达的影响。方法选取2016年1月~2018年6月解放军总医院第三医学中心收治的190例慢性心力衰竭患者,按随机数表法分为对照组(97例)和观察组(93例),对照组采用常规抗慢性心力衰竭治疗,观察组将常规抗慢性心力衰竭方案中的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,两组均持续治疗4个月。比较两组临床疗效,治疗前后呼吸困难程度及全身症状评分,心功能,血浆BNP、NO水平,生活质量变化情况和不良反应。结果治疗后,观察组总有效率高于对照组,差异有统计学意义(P <0.05)。两组治疗后呼吸困难程度及全身症状评分、左室舒张末期内径(LVEDD)、BNP、明尼苏达心力衰竭生活质量问卷(MLHFQ)评分均较治疗前下降,且观察组低于对照组,差异有统计学意义(P <0.05);两组左室射血分数(LVEF)、6 min步行距离(6MWT)、NO水平均较治疗前上升,观察组高于对照组,差异有统计学意义(P <0.05)。两组总不良反应发生率比较无统计学意义(P> 0.05)。结论 ARNI治疗心力衰竭的疗效较好、安全性高,能有效改善患者心功能,降低BNP水平并促进NO表达,从而提高患者生活质量。
Objective To analyze the effect of angiotensin receptor enkephalase inhibitors on cardiac function and the expression of B-type natriuretic peptide(BNP)and nitric oxide(NO)in patients with heart failure.Methods 190 patients with chronic heart failure were randomly divided into 97 control group and 93 observation group,the control group was treated with conventional anti-chronic heart failure therapy,the observation group replaced ACEI and ARB in the conventional anti-chronic heart failure regimen with shakuba valsartan.Both groups were treated for 4 months.Then clinical efficacy,changes of degree of dyspnea and systemic symptom score,cardiac function,plasma BNP and NO levels,quality of life before and after treatment,and adverse reactions were compared between the two groups.Results after treatment,the total effective rate in the observation group was higher than that in the control group(P < 0.05).After treatment,the scores of dyspnea and systemic symptoms,left ventricular end-diastolic diameter(LVEDD),BNP,and Minnesota heart failure quality of life questionnaire(MLHFQ)in the observation group were lower than in the control group.Left ventricular ejection fraction(LVEF),6-minute walking distance(6 MWT)and level of NO in both groups were higher than those before treatment,and the observation group was higher than the control group(P < 0.05).The total adverse reaction rate between the two groups was not statistically significant(P > 0.05).Conclusion ARNI has good efficacy and high safety in the treatment of heart failure,which can effectively improve the cardiac function of patients,reduce the level of BNP and promote the expression of NO,thereby improve the quality of life of patients.
作者
姜丽
乔延国
刘明贺
Jiang Li;Qiao Yanguo;Liu Minghe(South Building N0.2 Division,The Third Medical Center of PLA General Hospital,Beijing 100039,P.R.China)
出处
《中华保健医学杂志》
2020年第1期30-33,共4页
Chinese Journal of Health Care and Medicine
关键词
心力衰竭
血管紧张素受体脑啡肽酶抑制剂
心功能
B型利钠肽
一氧化氮
Heart failure
Angiotensin receptor enkephalase inhibitors
Cardiac function
B-type natriuretic peptide
Nitric oxide
