摘要
目的比较小剂量沙库巴曲缬沙坦与培哚普利治疗射血分数降低的慢性心力衰竭(HFrEF)患者6个月、12个月的临床疗效及安全性。方法回顾性分析2018年3月至2019年1月在华中科技大学同济医院心血管内科确诊为HFrEF并使用小剂量沙库巴曲缬沙坦或培哚普利治疗的112例HFrEF患者的临床资料,分为血管紧张素受体脑啡肽酶双重抑制剂(ARNI)组43例与血管紧张素转换酶抑制剂(ACEI)组69例,再按是否合并高血压分为ARNI组合并高血压21例与ACEI组合并高血压24例,按年龄分为ARNI青年亚组35例与ACEI青年亚组38例,比较两药物治疗的疗效及安全性。结果ARNI组治疗6、12个月后左心室射血分数(LVEF)显著提高(P=0.005),ARNI组治疗12个月左心室舒张末期内径(LVEDD)较治疗前显著缩小(P<0.001)。ARNI组治疗6个月后收缩压(SBP)、舒张压(DBP)显著降低(P<0.05),且与ACEI组相比,ARNI组患者SBP降低更明显(P<0.001),ARNI组患者治疗12个月后在随访过程中均无症状性低血压的发生。且ARNI组合并高血压患者治疗6、12个月LVEF显著提高(P<0.05)。ARNI组青年亚组治疗12个月LEVDD显著缩小,LVEF明显提高(P<0.001)。结论小剂量ARNI治疗HFrEF患者临床疗效等同于甚至优于ACEI,且HFrEF合并高血压患者的获益更大,对于青年HFrEF患者,小剂量ARNI的治疗也适用。
Objective To compare the clinical efficacy and safety of low-dose sacubitril/valsartan(ARNI)and perindopril in the treatment of patients with chronic heart failure with reduced ejection fraction(HFrEF)at 6 months and 12 months.Methods Clinical data of 112 patients with HFrEF who were diagnosed in Department of Cardiology,Tongji Hospital,Huazhong University of Science and Technology from March 2018 to January 2019 and treated with low-dose sacubitril/valsartan(ARNI)and perindopril were retrospectively analyzed.They were divided into ARNI group(n=43)and ACEI group(n=69).According to whether the patients were complicated with hypertension,they were divided into 21 cases of ARNI combined with hypertension and 24 cases of ACEI combined with hypertension,and they were divided in to 35 cases of ARNI young subgroup and 38 cases of ACEI young subgroup according to age.Compare the efficacy and safety of the two drug treatments.Results LVEF was significantly increased in the ARNI group after 6 and 12 months of treatment(P=0.005),LVEDD was significantly reduced in the ARNI group after 12 months of treatment(P<0.001).After 6 months of treatment,SBP and DBP in the ARNI group were significantly decreased(P<0.05),and compared with the ACEI group,SBP in the ARNI group was more significantly decreased(P<0.001).No symptomatic hypotension occurred in the ARNI group during the follow-up after 12 months of treatment.In addition,LVEF was significantly increased in patients with hypertension after 6 and 12 months of treatment with ARNI(P<0.05).After 12 months of treatment,LEVDD was significantly reduced(P<0.001)and LVEF was significantly increased(P<0.001)in the ARNI young subgroup.Conclusions The clinical efficacy of low-dose ARNI in the treatment of HFrEF patients is equal to or even better than that of ACEI,and the benefit for patients with HFrEF combined with hypertension is greater.For young patients with HFrEF,the treatment of lowdose ARNI is also applicable.
作者
本木措
王峰
倪黎
李瑞
马飞
余婷
赵春霞
BEN Mu-cuo;WANG Feng;NI Li;LI Rui;MA Fei;YU Ting;ZHAO Chun-xia(Department of Cardiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2021年第6期526-530,共5页
Chinese Journal of Practical Internal Medicine
基金
国家重点研发计划(项目编号:2017YFC1307600,课题编号:2017YFC1307602)。
