摘要
目的探讨沙库巴曲缬沙坦对高龄心力衰竭患者疗效及安全性。方法选取2021年1月—2022年6月在北京丰台医院确诊为心力衰竭的282例高龄患者。根据抽签结果将患者分为治疗组142例与对照组140例。对照组接受常规的抗心力衰竭药物治疗,包括洋地黄类强心药物、利尿剂、β-受体阻滞剂、醛固酮受体拮抗剂、血管紧张素Ⅱ受体拮抗剂、血管紧张素转换酶抑制剂(angiotensin converting enzyme inhibitors,ACEI)及扩血管药物,药物剂量根据患者的具体情况进行个体化调整。治疗组在常规心力衰竭治疗药物的基础上给予沙库巴曲缬沙坦片,起始剂量为50 mg,2次/d,随后根据患者的耐受情况加至200 mg,2次/d。比较2组治疗前后6 min步行试验(6 minutes walking test,6MWT)结果、左室射血分数(left ventricular ejection fraction,LVEF)、左室短轴缩短率(left ventricular short axis shortening rate,FS)、血浆N末端脑钠肽(plasma N-terminal brain natriuretic peptide,NT-proBNP)水平、肾功能和血压情况。结果治疗后,治疗组6MWT结果为(304.12±41.51)m,高于对照组的(224.25±35.29)m(P<0.05);治疗组LVEF、FS分别为(44.72±6.74)%、(21.72±4.34)%,高于对照组的(40.31±8.42)%、(14.63±4.11)%(P<0.05);治疗组NT-proBNP水平为(1396.05±42.35)pg/mL,低于对照组的(3421.42±52.32)pg/mL(P<0.05);在整个治疗过程中,未观察到明显的低血压、肾功能恶化等不良反应。结论沙库巴曲缬沙坦在治疗高龄心力衰竭患者中表现出良好的安全性和有效性。
Objective To investigate the effect and safety of sacubitril/valsartan on elderly patients with heart failure.Methods A total of 282 elderly patients diagnosed with heart failure in Beijing Fengtai Hospital from January 2021 to June 2022 were selected.According to the results of lottery,the patients were divided into the treatment group(n=142)and the control group(n=140).The control group was given conventional antiheart failure drugs,including digitoxin cardiac drugs,diuretics,β-blockers,aldosterone receptor antagonists,angiotensinⅡreceptor antagonists,angiotensin converting enzyme inhibitors(ACEI)and vasodilators,and the drug dosage was adjusted according to the individual patients.The treatment group was given sacubitril/valsartan on the basis of conventional heart failure treatment drugs,the initial dose was 50 mg,twice/day,and then gradually increased to 200 mg,twice/day according to tolerance.The results of 6 minutes walking test(6MWT),left ventricular ejection fraction(LVEF),left ventricular short axis shortening rate(FS),plasma N-terminal brain natriuretic peptide(NT-proBNP),renal function and blood pressure were compared between the two groups before and after treatment.Results After treatment,the 6MWT of the treatment group was(304.12±41.51)m,which was higher than(224.25±35.29)m of the control group(P<0.05).The LVEF and FS in the treatment group were(44.72±6.74)%and(21.72±4.34)%,respectively,higher than(40.31±8.42)%and(14.63±4.11)%in the control group(P<0.05).The level of NT-proBNP in the treatment group was(1396.05±42.35)pg/mL,which was lower than(3421.42±52.32)pg/mL in the control group(P<0.05).No adverse reactions such as hypotension and deterioration of renal function were observed during the whole course of treatment.Conclusion Sacubitril/valsartan has shown good safety and efficacy in the treatment of elderly patients with heart failure.
作者
张健
于凝
ZHANG Jian;YU Ning(Department of Cardiovascular Medicine,Beijing Fengtai Hospital,Beijing 100070,China)
出处
《中国卫生标准管理》
2024年第18期121-124,共4页
China Health Standard Management
基金
北京丰台医院科学研究项目(2022-07)。
关键词
高龄
心力衰竭
左室射血分数
沙库巴曲缬沙坦
疗效
安全性
elderly patients
heart failure
left ventricular ejection fraction
sacubitril/valsartan
efficacy
safety
