摘要
目的 分析应用沙库巴曲缬沙坦对急性失代偿心力衰竭(下称心衰)患者预后的影响。方法 选择2017年10月至2021年2月在衢州市人民医院就诊的初发急性失代偿心衰患者189例,其中应用沙库巴曲缬沙坦治疗84例(观察组),应用血管紧张素转化酶抑制剂(ACEI)或血管紧张素Ⅱ受体拮抗剂(ARB)治疗105例(对照组),比较两组患者治疗前和治疗3个月后的N末端脑钠肽前体(NT-proBNP)、肌钙蛋白I(cTnI),左心室射血分数(LVEF)改善≥10%比例、LVEF>50%比例、左心室舒张末期内径(LVEDd)缩小≥5 mm比例和再入院率。应用Cox回归分析应用沙库巴曲缬沙坦与预后的关系。结果观察组患者LVEF改善≥10%比例、LVEF>50%比例、LVEDd缩小≥5 mm比例高于对照组,差异均有统计学意义(均P<0.05)。两组患者NT-proBNP和cTnI水平比较,差异均无统计学意义(均P>0.05)。观察组心衰再入院发生率低于对照组,差异有统计学意义(P<0.05)。Cox回归分析显示,沙库巴曲缬沙坦与LVEF改善≥10%、LVEF>50%、LVEDd缩小≥5 mm和心衰再入院率均独立相关(均P<0.05)。结论 沙库巴曲缬沙坦有助于改善急性失代偿心力衰竭患者心功能,降低再入院风险。
Objective To investigate the effect of sacubitril valsartan on the prognosis of patients with acute decompensated heart failure(ADHF). Methods Clinical data of 189 patients with new-onset ADHF in Quzhou People’s Hospital from October 2017 to February 2021 were retrospectively analyzed. Of them, 84 patients were treated with sacubitril valsartan(observation group) and 105 patients were treated with ACEI or ARB(control group).NT-proBNP and c TnI before treatment and 3 months after treatment, the proportion of cases with improvement of left ventricular ejection fraction(LVEF)≥10%, LVEF>50%, or reduction of left ventricular end-diastolic diameter(LVEDd)≥5 mm and readmission rate were compared between the two groups. Cox regression analysis was performed to analyze the relationship between sacubitril valsartan and prognosis. Results The proportion of patients with LVEF improvement ≥10%, LVEF>50% and LVEDd reduction ≥5 mm were significantly higher in the observation group than in the control group(all P<0.05). NT-proBNP and cTnI were not significantly different between the two groups(both P >0.05). The incidence of readmission for heart failure was significantly lower in the observation group than in the control group(all P<0.05). Cox multiple regression analysis showed that the treatment with sacubitril valsartan was independently correlated with LVEF improvement ≥10%, LVEF>50%, LVEDd reduction ≥5 mm and heart failure readmission(all P<0.05). Conclusion Application of sacubitril valsartan can improve cardiac function of patients with ADHF and reduce rehospitalization.
作者
徐红青
屠晓鸣
高珍艳
吴叶顺
吴梦琦
余春燕
XU Hongqing;TU Xiaoming;GAO Zhenyan;WU Yeshun;WU Mengqi;YU Chunyan(Department of Cardiology,Quzhou People's Hospital,Quzhou 324000,China;不详)
出处
《心电与循环》
2023年第1期53-56,65,共5页
Journal of Electrocardiology and Circulation
