摘要
目的:探讨不同剂量沙库巴曲缬沙坦对高龄老年慢性心力衰竭患者的疗效及安全性。方法:将2019—2021年该院收治的155例高龄老年慢性心力衰竭患者按给药剂量不同分为A组(35例)、B组(62例)和C组(58例)。A组患者给予沙库巴曲缬沙坦1次100 mg,1日2次(标准剂量);B组患者给予沙库巴曲缬沙坦1次50 mg,1日2次(降低剂量);C组患者给予沙库巴曲缬沙坦1次25 mg,1日2次(降低剂量)。三组患者均连续用药12个月后,比较治疗前后的总有效率、心脏结构和功能的改善情况以及不良事件发生情况等。结果:治疗后,A、B和C组患者的总有效率分别为94.3%(33/35)、90.3%(56/62)和69.0%(40/58),差异有统计学意义(P<0.001)。治疗后,A、B组患者的左心室射血分数分别为(63.07±7.95)%、(55.52±11.31)%,较治疗前明显改善,且A组患者较B组改善更明显,而C组患者无明显改善;A、B组患者的左心房内径分别为(38.04±7.04)、(39.14±5.67)mm,较治疗前明显改善,而C组患者无明显改善;A、B组患者的左心室舒张末内径分别为(46.03±6.91)、(48.80±6.95)mm,较治疗前明显改善,而C组患者无明显改善。三组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:使用沙库巴曲缬沙坦治疗高龄老年慢性心力衰竭患者时,如果考虑危险因素多,不能耐受标准剂量,可使用1次50 mg、1日2次的降低剂量,可能会有同样的临床获益,但不推荐1次25 mg、1日2次的降低剂量。
OBJECTIVE:To probe into the efficacy and safety of different doses of sacubitril valsartan in the treatment of elderly patients with chronic heart failure.METHODS:A total of 155 elderly patients with chronic heart failure admitted into the hospital from 2019 to 2021 were divided into the group A(n=35),group B(n=62)and group C(n=58)according to different dosage regimen.Group A was given 100 mg sacubitril valsartan twice a day(standard dose),group B received 50 mg sacubitril valsartan twice a day(lower dose),group C was treated with 25 mg sacubitril valsartan twice a day(lower dose).After continuous medication for 12 months,the total effective rate,improvement in cardiac structure and function,and incidence of adverse events were compared among three groups before and after treatment.RESULTS:After treatment,the total effective rates of the three groups were respectively 94.3%(33/35),90.3%(56/62)and 69.0%(40/58),with statistically significant differences(P<0.001).After treatment,the left ventricular ejection fraction in group A and group B was respectively(63.07±7.95)%and(55.52±11.31)%,which were significantly improved compared with those before treatment,and the improvement in group A was more significant than that in group B,while there was no significant improvement in group C.The left atrial diameter of patients in group A and group B was respectively(38.04±7.04)mm and(39.14±5.67)mm,which was significantly improved compared with those before treatment,while there was no significant improvement in group C.The left ventricular end-diastolic diameter in group A and group B was respectively(46.03±6.91)mm and(48.80±6.95)mm,which were significantly improved compared with those before treatment,while there was no significant improvement in group C.There was no significant difference in the incidence of adverse drug reactions among three groups(P>0.05).CONCLUSIONS:In the treatment of chronic heart failure in elderly patients,if multiple risk factors are considered and the standard dose cannot be tolerated,a reduce
作者
张显玲
牟钰钦
李玥
ZHANG Xianling;MOU Yuqin;LI Yue(Dept.of Pharmacy,the Ninth People’s Hospital of Chongqing,Chongqing 400700,China;Dept.of Cardiology,the Ninth People’s Hospital of Chongqing,Chongqing 400700,China)
出处
《中国医院用药评价与分析》
2024年第3期287-290,共4页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
重庆市卫生健康委医学科研项目(No.2023WSJK031)。
关键词
沙库巴曲缬沙坦
心力衰竭
不同剂量
疗效
Sacubitril valsartan
Chronic heart failure
Different doses
Clinical efficacy
