摘要
目的:研究沙库巴曲缬沙坦治疗尿毒症维持性血液透析合并心力衰竭患者的疗效。方法:选取2020年6月就诊于芜湖市第一人民医院的尿毒症维持性血液透析合并心力衰竭患者68例,随机分成研究组和对照组,对照组接受常规治疗,包括维持性血液透析、维持水及电解质稳定、调节血脂、控制血压、控制血糖等;研究组在对照组基础上加用沙库巴曲缬沙坦,随访9个月,对比两组射血分数及N末端脑钠肽前体(NT-proBNP)。结果:研究组治疗后3、6、9个月左心室射血分数均较治疗前有所上升(P<0.05);而对照组治疗后6、9个月左心室射血分数均较治疗前、治疗后3个月有所上升(P<0.05),治疗后9个月左心室射血分数也较治疗后6个月有所上升(P<0.05)。研究组治疗后6、9个月NT-proBNP均较治疗前、治疗后3个月有所下降(P<0.05),治疗后9个月NT-proBNP有所下降(P<0.05);而对照组治疗后9个月均较治疗前、治疗后3个月有所下降(P<0.05)。研究组治疗后9个月左心室射血分数、NT-proBNP均较对照组明显改善(P<0.05)。结论:沙库巴曲缬沙坦可以有效提高尿毒症维持性血液透析患者射血分数,并降低NT-proBNP水平,改善患者心功能,其效果优于传统内科治疗。
Objective:To observe the curative effect of sacubitril/valsartan in the treatment of uremic patients concomitant with heart failure undergoing maintenance hemodialysis.Methods:Sixty-eight uremic patients with heart failure undergoing maintenance hemodialysis in Wuhu No.1 People′s Hospital in June 2020 were included,and randomly allocated to observational group and control group.Patients in the control group just received conventional treatment regimen,including maintenance hemodialysis,maintaining of stability of water and electrolyte,regulation of blood lipid,control of blood pressure and blood glucose level,and those in the observational group were given additional sacubitril/valsartan on the conventional treatment regimen basis.N-terminal pro-brain natriuretic peptide(NT-proBNP)level and left ventricular ejection fraction(LVEF)were monitored and compared between groups.All patients were follow for 9 months.Results:The LVEF was generally elevated in the patients in the observational group at month 3,6 and 9 after therapy(P<0.05).Elevated LVEF was seen in patients in the control group at month 6 and 9 after treatment compared to the LVEF before therapy and 3 month after medication(P<0.05),and the increase of LVEF was more obvious at month 9 than at month 6 after treatment(P<0.05).NT-proBNP level was decreased in 6 and 9 months compared with that before treatment and 3 months after treatment in patients in the observational group(P<0.05),and also decreased in 9 months compared with that in 6 months after treatment(P<0.05),whereas decreased NT-proBNP level was seen in at month 9 compared to that before therapy and 3 months after therapy(P<0.05).Improvement of LVEF and NT-proBNP at month 9 after treatment was better in the observational group than in control group(P<0.05).Conclusion:Sacubitril/valsartan can effectively improve LVEF and reduce NT proBNP level as well boost the cardiac function of uremic patients undergoing maintenance hemodialysis,which suggests that this regimen is superior to conventional medica
作者
陈欣
史铭
曹鹏
曹玉莲
张兴波
CHEN Xin;SHI Ming;CAO Peng;CAO Yulian;ZHANG Xingbo(Department of Blood Purification Centre,Wuhu No.1 People′s Hospital,Wuhu 241000 China)
出处
《皖南医学院学报》
CAS
2022年第5期471-473,共3页
Journal of Wannan Medical College
基金
芜湖市科技计划项目(2020ms3-16)。
