摘要
目的探讨沙库巴曲缬沙坦联合螺内酯、酒石酸美托洛尔治疗老年射血分数降低的心力衰竭(heart failure with reduced ejection fraction,HFrEF)的疗效及对患者心功能及血清N末端脑钠肽前体(N-terminal probrain natriuretic peptide,NT-proBNP)水平的影响。方法选取收治的120例老年HFrEF患者作为研究对象,用随机数字表法分为对照组(60例)和观察组(60例)。2组均给予常规治疗,对照组给予螺内酯片联合酒石酸美托洛尔片,观察组在对照组治疗的基础上给予沙库巴曲缬沙坦钠片。2组均持续治疗2个月。比较治疗2个月后的临床疗效,治疗前、治疗2个月后的6 min步行试验距离(6-minute walk test,6MWT)、尿量、心肌评估参数、NT-proBNP、醛固酮和血肌酐水平,治疗期间的再入院率及不良反应。结果治疗2个月后,观察组的总有效率(91.67%)高于对照组(76.67%),P<0.05。与治疗前比较,2组6MWT、尿量、左室射血分数(left ventricular ejection fractions,LVEF)、每分钟心排血量(cardiac output,CO)和心排血指数(cardiac output index,CI)均升高,且观察组高于对照组;2组的心率(heart rate,HR)、血清NT-proBNP和醛固酮水平均降低,且观察组低于对照组(P<0.05)。治疗期间,观察组的再入院率(13.33%)低于对照组(30.00%),P<0.05;观察组不良反应发生率(13.33%)与对照组(15.00%)比较差异无统计学意义。结论沙库巴曲缬沙坦联合螺内酯、酒石酸美托洛尔能有效改善老年HFrEF患者心功能及血清NT-proBNP水平,提高患者6MWT,降低患者的再入院率,安全性良好。
Objective To investigate the efficacy of sacubitril-valsartan combined with spironolactone and metoprolol tartrate in the treatment of elderly patients with mental failure and decreased ejection fraction(HFrEF),and its effects on cardiac function and the level of serum N-terminal pro brain natriuretic peptide(NT proBNP).Methods A total of 120 elderly patients with HFrEF were selected as the research subjects,and divided into control group(60 cases)and observation group(60 cases)by random number table method.The both groups were given routine treatment.The control group was given Spironolactone Tablets combined with Metoprolol Tartrate Tablets,and the observation group was given Sacubitril Valsartan Sodium Tablets on the basis of the control group,treated continuously for 2 months.The clinical efficacy of the 2 groups after 2 months of treatment,the 6-minute walking test distance(6MWT),urine volume,myocardial evaluation parameters,and the levels of serum NT-proBNP,aldosterone,serum creatinine before and after 2 months of treatment,readmission rates and adverse reactions during the treatment between the 2 groups were compared.Results After 2 months of treatment,the total effective rate in the observation group(91.67%)was higher than in the control group(76.67%),P<0.05.Compared with before treatment,the 6MWT,urine volume,left ventricular ejection fraction(LVEF),cardiac output per minute(CO)and cardiac output index(CI)in the 2 groups all increased,and the observation group was higher than the control group;the heart rate(HR),the levels of serum NT-proBNP and aldosterone in both groups decreased,and the observation group was lower than the control group(P<0.05).During the treatment period,the readmission rate in the observation group(13.33%)was lower than the control group(30.00%),P<0.05.There was no significant difference between the observation group(13.33%)and the control group(15.00%)in the incidence of adverse reactions.Conclusion Sacubitril-valsartan combined with spironolactone and metoprolol tartrate could eff
作者
张青青
李晓增
乔香玲
李欣
ZHANG Qingqing;LI Xiaozeng;QIAO Xiangling;LI Xin(Intracardiac CCU of Xingtai Third Hospital,Xingtai 054099,China;Department One of Cardiology,Xingtai Third Hospital,Xingtai 054099,China)
出处
《西北药学杂志》
CAS
2024年第2期206-210,共5页
Northwest Pharmaceutical Journal
基金
邢台市重点研发计划项目(编号:2020ZC339)。
关键词
沙库巴曲缬沙坦
螺内酯
心力衰竭
射血分数
心功能
sacubitril-valsartan
spironolactone
heart failure
ejection fraction
cardiac function
