摘要
目的观察沙库巴曲缬沙坦治疗射血分数中间值的心力衰竭(HFmrEF)、射血分数保留的心力衰竭(HFpEF)伴肺动脉收缩压(PASP)升高患者的临床疗效。方法选取长沙东协盛医院2019—2020年收治的HFmrEF、HFpEF伴PASP升高患者102例为研究对象,按照随机数字表法分为对照组和观察组,各51例。患者入院后均行常规治疗,对照组予以盐酸贝那普利,观察组予以沙库巴曲缬沙坦,2组均持续治疗6个月。比较2组临床疗效及治疗前后超声心动图检查指标[左心房内径(LAD)、右房室瓣反流速率峰值(TRV)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、右心室舒张末期内径(RVEDD)、PASP]、心率、6分钟步行距离(6MWD)、堪萨斯市心肌病变问卷总体汇总评分(KCCQ-OSS-15)、实验室检查指标[尿素氮(BUN)、肌酐(Cr)、钠离子(Na+)、钾离子(K+)、氯离子(Cl-)]及住院时间、住院次数,不良事件发生率。结果观察组总有效率为94.12%,高于对照组的78.43%(χ^(2)=5.299,P=0.021)。治疗后,2组LAD、TRV、LVEDD、RVEDD、PASP小于治疗前,LVEF高于治疗前,且观察组LAD、TRV、LVEDD、RVEDD、PASP小于对照组,LVEF高于对照组(P<0.05)。治疗后,2组心率低于治疗前,6MWD长于治疗前,KCCQ-OSS-15高于治疗前,且观察组心率低于对照组,6MWD长于对照组,KCCQ-OSS-15高于对照组(P<0.05)。2组治疗前及治疗后BUN、Cr、Na+、K+、Cl-比较,差异无统计学意义(P>0.05)。观察组住院时间短于对照组,住院次数少于对照组(P<0.01)。2组症状性低血压、高钾血症、心源性不良事件、肾功能损伤发生率比较,差异无统计学意义(P>0.05)。结论采用沙库巴曲缬沙坦治疗HFmrEF、HFpEF伴PASP升高患者的临床疗效确切,可有效改善患者的心室重构及心功能,降低PASP,提高患者运动耐量及生活质量,缩短住院时间,且不会对患者肾功能造成较大影响,安全性较高。
Objective To observe the clinical effect of sacubitril and valsartan in the treatment of heart failure with median ejection fraction(HFmrEF),heart failure with preserved ejection fraction(HFpEF)patients accompanied with elevated pulmonary artery systolic pressure(PASP).Methods A total of 102 cases of HFmrEF,HFpEF patients accompanied with elevated PASP were selected from 2019 to 2020 in Changsha East Xiesheng Hospital,which were divided into control group and observation group according to random number table method,51 cases in each group.All patients were given conventional therapy,patients in control group were given benazepril hydrochloridec,patients in observation group were given sacubitril and valsartan,both groups were continuously treated for 6 months.Clinical effect,echocardiographic examination indexes(LAD,TRV,LVEDD,LVEF,RVEDD,PASP),heart rate,6MWD,KCCQ-OSS-15,laboratory inspection indexes(BUN,Cr,Na+,K+,Cl-)before and after treatment,length of hospital stay,times of hospitalization,incidence of adverse event were compared between the two groups.Results Total effective rate in observation group was 94.12%,which was higher than 78.43%of control group(χ^(2)=5.299,P=0.021).After treatment,LAD,TRV,LVEDD,RVEDD,PASP in the two groups were less than those before treatment,LVEF was higher than that before treatment,and LAD,TRV,LVEDD,RVEDD,PASP in observation group were less than those in control group,LVEF was higher than that in control group(P<0.05).After treatment,heart rate in the two groups was lower than that before treatment,6MWD was longer than that before treatment,KCCQ-OSS-15 was higher than that before treatment,and heart rate in observation group was lower than that in control group,6MWD was longer than that in control group,KCCQ-OSS-15 was higher than that in control group(P<0.05).There was no significant difference of BUN,Cr,Na+,K+,Cl-between the two groups before and after treatment(P>0.05).Length of hospital stay in observation group was shorter than that in control group,times of hospitalizatio
作者
朱小霞
ZHU Xiaoxia(Changsha East Xiesheng Hospital,Changsha 410000,China)
出处
《临床合理用药杂志》
2022年第15期8-11,15,共5页
Chinese Journal of Clinical Rational Drug Use
关键词
心力衰竭
射血分数中间值的心力衰竭
射血分数保留的心力衰竭
肺动脉收缩压
沙库巴曲缬沙坦
治疗结果
Heart failure
Heart failure with median ejection fraction
Heart failure with preserved ejection fraction
Pulmonary artery systolic pressure
Sacubitril and valsartan
Treatment outcome
