摘要
目的探讨沙库巴曲缬沙坦治疗慢性心力衰竭肺动脉高压的疗效及对患者血清可溶性细胞间黏附分子-1(sICAM-1)、可溶性白细胞分化抗原40配体(sCD40L)的影响。方法选择2016年8月至2017年9月武警陕西省总队医院心内科收治的90例慢性心力衰竭肺动脉高压患者为研究对象,按随机数表法分为观察组和对照组各45例。在常规治疗基础上对照组给予缬沙坦治疗,观察组则给予沙库巴曲缬沙坦治疗,两组均连续治疗10 d。比较两组患者的临床疗效,以及治疗前后的心功能、肺功能、血清s ICAM-1、sCD40L指标改善情况和不良反应。结果治疗后,观察组患者的临床治疗总有效率为95.56%,明显高于对照组的82.22%,差异有统计学意义(P<0.05);治疗后,观察组患者的左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)分别为(50.04±3.38)mm、(40.51±3.24)mm,明显低于对照组的(57.96±3.01)mm、(48.26±3.70)mm,左室射血分数(LVEF)为(58.64±3.18)%,明显高于对照组的(47.52±2.64)%,差异均有统计学意义(P<0.05);治疗后,观察组患者的第一秒最大呼气容积(FEV1)、FEV1与用力肺活量比值(FEV1/FVC)、最大呼气流量(PEF)分别为(1.60±0.43)L、(73.07±6.35)%、(3.74±1.10)L/s,明显高于对照组的(1.29±0.37)L、(64.72±5.88)、(3.02±0.83)L/s,差异均有统计学意义(P<0.05);治疗后,观察组患者的血清sICAM-1和s CD40L分别为(0.79±0.13)μg/L、(14.53±1.26)ng/mL,明显低于对照组的(1.24±0.15)μg/L、(17.06±1.31)ng/mL,差异均有统计学意义(P<0.05);观察组患者的不良反应总发生率为4.44%,略低于对照组的8.89%,但差异无统计学意义(P>0.05)。结论慢性心力衰竭肺动脉高压患者临床治疗中使用沙库巴曲缬沙坦能改善患者心功能和肺功能,调节血清sICAM-1、sCD40L水平,临床治疗效果显著。
Objective To study the therapeutic effect of Sacubitril/Valsartan on 45 patients with chronic heart failure and pulmonary hypertension and its effect on serum soluble intercellular adhesion molecule-1(sICAM-1) and soluble leukocyte differentiation antigen 40 Ligand(sCD40L). Methods Ninety patients with chronic heart failure and pulmonary hypertension from August 2016 to September 2017 in Department of Cardiology, Shaanxi Provincial Corps Hospital, Chinese People’s Armed Police Forces, were selected as the research subjects. According to the method of random number table, the patients were divided into the observation group and the control group, with 45 patients in each group. On the basis of routine treatment, the control group was treated with Valsartan, while the observation group was treated with Sacubitril/Valsartan, continuously for 10 days. The clinical efficacy, cardiac function, lung function, sICAM-1, and s CD40 L before and after treatment were compared between the two groups. Results After treatment, the total effective rate of clinical treatment in the observation group patients was 95.56%, which was significantly higher than 82.22% in the control group(P<0.05). After treatment, the left ventricular end-diastolic diameter(LVEDD) and left ventricular end-systolic diameter(LVESD) in the observation group patients were(50.04±3.38) mm and(40.51±3.24) mm,which were significantly lower than(57.96±3.01) mm,(48.26±3.70) mm in the control group(P<0.05);the left ventricular ejection fraction(LVEF) were(58.64 ± 3.18)%, which was significantly higher than(47.52 ± 2.64)% in the control group(P<0.05);the maximum expiratory volume(FEV1), ratio of FEV1 to forced vital capacity(FEV1/FVC), and maximum expiratory flow(PEF) in the observation group were(1.60±0.43) L,(73.07±6.35)%,(3.74±1.10) L/s, respectively,which were significantly higher than(1.29±0.37) L,(64.72±5.88)%,(3.02±0.83) L/s in the control group(P<0.05);the sICAM-1 and sCD40L in the observation group were(0.79±0.13) μg/L,(14.53±1.26) ng/mL, which were significantly lower than(1.24±0.15) μg/L,(17.06±1.31) ng/mL in the control group(P<0.05);the total incidence of adverse reactions in the observation group patients was 4.44%, slightly lower than 8.89% in the control group(P>0.05). Conclusion In the clinical treatment of patients with chronic heart failure and pulmonary hypertension, Sacubitril/Valsartan can improve the heart function and pulmonary function, regulate the levels of serum sICAM-1 and sCD40L, with significant clinical treatment effect.
作者
孙静
寇进
胡建库
黄辉
SUN Jing;KOU Jin;HU Jian-ku;HUANG Hui(Department of Cardiology,Shaanxi Provincial Corps Hospital,Chinese People's Armed Police Forces,Xi'an 710054,Shaanxi,CHINA)
出处
《海南医学》
CAS
2020年第2期149-152,共4页
Hainan Medical Journal
关键词
沙库巴曲缬沙坦
缬沙坦
慢性心力衰竭
肺动脉高压
心功能
肺功能
可溶性细胞间黏附分子-1
可溶性白细胞分化抗原40配体
Sacubitril/Valsartan
Valsartan
Chronic heart failure
Pulmonary hypertension
Cardiac function
Pulmonary function
Soluble intercellular adhesion molecule-1(sICAM-1)
Soluble leukocyte differentiation antigen 40 ligand(sCD40L)
