摘要
目的:研究常规治疗联合低剂量沙库巴曲缬沙坦治疗慢性心力衰竭(CHF)疗效与安全性。方法:将佛山市第一人民医院2017.11至2019.05间收治的84例CHF患者随机均分为观察组与对照组,对照组采用常规治疗,观察组在常规治疗停止使用血管紧张素转换酶抑制剂(ACEI)后使用低剂量沙库巴曲缬沙坦,比较两组治疗效果与药物安全性。结果:两组经治疗后,左心室射血分数(LVEF)水平较同组治疗前均显著上升(P<0.05),左室舒张末期内径(LVEDD)及舒张末期容积(LVEDV)水平均较同组治疗前显著下降(P<0.05),且观察组经治疗后,LVEDD及LVEDV水平均低于对照组(P<0.05);两组治疗后,收缩压(SBP)、舒张压(DBP)及心率均较同组治疗前下降(P<0.05),观察组经治疗后,SBP、DBP及心率水平均低于对照组(P<0.05);两组治疗后,6 min步行距离均较同组治疗前显著提高(P<0.05),血清NT-proBNP水平均较同组治疗前显著下降(P<0.05),且观察组经治疗后6min步行距离远于对照组(P<0.05),血清N-末端脑钠肽(NT-proBNP)水平低于对照组(P<0.05);两组治疗有效率差异无统计学意义(P>0.05);两组治疗不良反应差异无统计学意义(P>0.05)。结论:常规治疗基础上联合低剂量沙库巴曲缬沙坦能有效抑制CHF患者心室重塑进程,改善患者临床症状,且药物不良反应低。
Objective:To investigate the efficacy and safety of conventional therapy combined with low-dose sacubitril valsartan in the treatment of chronic heart failure(CHF).Methods:A total of 84 patients with CHF admitted to Foshan First People’s Hospital between November 2017 and May 2019 were randomly divided into the study group and control group.The control group received conventional therapy,and the study group received conventional therapy with addition of low-dose sacubitril valsartan after withdrawal of angiotensin-converting enzyme inhibitor(ACEI).The therapeutic efficacy and drug safety were compared between the two groups.Results:After treatment,the two groups experienced significant increase in left ventricular ejection fraction(LVEF)(P<0.05),and reductions in the left ventricular end-diastolic diameter(LVEDD)and end-diastolic volume(LVEDV)(P<0.05),compared with baseline.After treatment,the LVEDD and LVEEDV in the study group were smaller than those in the control group(P<0.05).After treatment,the two groups experienced significant reductions in systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate,compared with baseline(P<0.05).After treatment,the levels of SBP,DBP and heart rate in the study group were lower than those in the control group(P<0.05).After treatment,the two groups experienced significant increase in the 6-minute walking distance(6MWD)and reduction in serum level of N-terminal brain natriuretic peptide(NT-proBNP),compared with baseline(P<0.05);the study group showed longer 6MWD(P<0.05)and lower serum level of NT-proBNP,compared with the control group(P<0.05).There was no statistically significant difference in treatment response(P>0.05),nor in treatment-related adverse reactions(P>0.05)between the two groups.Conclusion:In patients with CHF,addition of low-dose sacubitril valsartan to conventional therapy may effectively inhibit the process of ventricular remodeling,improve clinical symptoms,and is associated with less adverse drug reactions.
作者
张健瑜
梁茜
蔡伟标
杨希立
Zhang Jianyu;Liang Qian;Cai Weibiao;Yang Xili(Department of Cardiology,Foshan First People’s Hospital,Foshan 528000,Guangdong,China)
出处
《广州医科大学学报》
2020年第3期7-10,共4页
Academic Journal of Guangzhou Medical University
