摘要
目的:探讨高龄老年高血压合并射血分数保留心力衰竭(HFpEF)患者,沙库巴曲缬沙坦钠(ARNI)治疗的临床效果。方法:采用队列资料分析,选取2020年1月至2020年6月,共计120例≥75岁老年高血压合并HFpEF患者。资料匹配分组:沙库巴曲缬沙坦钠(ARNI)治疗组和培哚普利吲达帕胺治疗组,每组各60例。记录基线和3个月随访时患者血压,心功能水平(NYHA分级),KCCQ生活质量评分,血浆NT-proBNP水平和肾功能水平。结果:培哚普利吲达帕胺治疗组和ARNI治疗组患者基线收缩压是[(161.82±8.87)vs.(162.27±9.02)mmHg,P=0.78],舒张压是[(82.57±12.75)vs.(83.37±12.57)mmHg,P=0.77]。两组3个月随访收缩压是[(137.53±9.19)vs.(134.13±8.34)mmHg,P=0.04]。两组患者收缩压达标率是[32/60(53.3%)和41/60(68.3%),P=0.09]。3个月时两组LVEF是[(56.3±3.4)%vs.(55.9±3.6)%,P>0.05]差异无统计学意义。两组NYHA心功能分级改善是[44/60(73.3%)vs.35/60(58.3%),P=0.08]。两组3个月时KCCQ评分别是[(55.45±6.04)vs.(52.80±7.28)分,P=0.03]。结论:针对≥75岁老年高血压合并HFpEF患者,ARNI与培哚普利吲达帕胺治疗组相比,收缩压达标率相当,但ARNI在提高患者短期生活质量方面具有优势。
Objective:To investigate the clinical efficacy of sacubitril valsartan sodium or perindopril/indapamide in the treatment of old patients with hypertension and preserved ejection fraction heart failure(HFpEF).Methods:Using cohort study,120 hypertensive patients with HFpEF(NYHA class Ⅱ-Ⅲ)were enrolled in Beijing Anzhen Hospital from Jan 1,2020 to June 30,2020,and were equally stratified into the Perin-dopril/Indapamide group(n=60)and the Sacubitril Valsartan Sodium group(n=60).The patients'blood pressure,LVEF,heart function(NYHA)class,the Kansas city cardiomyopathy questionnaire Score(KCCQ),NT-proBNP and Scr were recorded at baseline and 3 months follow up.Results:The baseline blood pressure were equal in the two group,while SBP was lower in ARNI group than the Perindopril/Indapamide group at 3 month[(134.13±8.34)vs.(137.53±9.19)mmHg,P=0.04].SBP control rate was similar in the two treatment groups[41/60(68.3%);32/60(53.3%),P=0.09].There was no difference in LVEF between the two treatment groups at baseline and 3 month follow up,and the improvement of heart function did not reach the significance at 3 month.The improvement rates were[44/60(73.3%)vs.35/60(58.3%),P=0.08].The KCCQ was higher in ARNI group than the PerindopriL/Indapamide group[(55.45±6.04)vs.(52.80±7.28),P=0.03].Conclusions:To the old patients older than 75 years,the blood pressure control was similar between ARNI and Perindopril/Indapamide treatment,the LVEF also had no difference between the two groups,but the KCCQ was higher in ARNI group than the PerindopriL/Indapamide group,suggesting the living quality was higher in the ARNI group.
作者
李蕾
杨红
王韶屏
李世英
LI Lei;YANG Hong;WANG Shaoping;LI Shiying(Department of Traditional Chinese Medicine,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)
出处
《心肺血管病杂志》
CAS
2021年第11期1117-1121,共5页
Journal of Cardiovascular and Pulmonary Diseases
关键词
高血压
射血分数保留心力衰竭
沙库巴曲缬沙坦钠
Hypertension
Heart failure with preserved ejection fraction
Sacubitril一valsartan
