摘要
目的比较沙库巴曲/缬沙坦与贝那普利治疗射血分数降低的慢性心力衰竭(HFrEF)患者的临床疗效,并分析其对左心重构和超敏肌钙蛋白T(hs-cTnT)水平的影响。方法选取2018年6月至2019年6月于徐州医科大学附属常熟医院诊治的HFrEF患者,采用随机数字法分为对照组和观察组。两组患者均给予常规抗心力衰竭(心衰)药物治疗,对照组给予贝那普利,观察组同时给予沙库巴曲/缬沙坦,治疗24周。比较两组患者的N末端脑钠肽(NT-proBNP)、超敏肌钙蛋白T(hs-cTnT)、左室射血分数(LVEF)、6 min步行试验(6MWT)、明尼苏达心衰量表评分(MLHFQ)和不良心血管事件(死亡、心衰再入院率)等。结果治疗24周后,观察组患者的临床有效率(85.1%)明显高于对照组(64.6%),差异有统计学意义(P<0.05)。观察组的NT-proBNP、hs-cTnT、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)及MLHFQ较治疗前降低,LVEF、心脏指数(CI)及6MWT较治疗前明显升高,差异有统计学意义(P均<0.05);治疗24周后,与对照组相比,观察组患者hs-cTnT、MLHFQ明显降低,LVEF、CI及6MWT显著升高,差异有统计学意义(P均<0.05)。观察组因心衰再入院率低于对照组[12例(25.5%)vs.22例(45.8%),P<0.05],两组均无心源性死亡。结论沙库巴曲/缬沙坦治疗HFrEF患者安全有效,较贝那普利能显著改善HFrEF患者的运动耐力及左心功能,降低hs-cTnT的水平,并减少因心衰加重再入院率。
Objective To compare the clinical efficacy of sakubatril/valsartan and benazepril on heart failure with reduced ejection fraction(HFrEF),and analyze their influence on left ventricular remodeling and level of high sensitivity cardiac troponin T(hs-cTnT).Methods HFrEF patients were chosen from Changshu Hospital affiliated to Xuzhou Medical University from June 2018 to June 2019,and divided into control group and observation group by using random digital method.All groups were treated with routine anti-HF drugs and additionally control group was given benazepril and observation group was given sakubatril/valsartan for 24 weeks.The indexes of N-terminal pro-brain natriuretic peptide(NT-proBNP),hs-cTnT,left ventricular ejection fraction(LVEF),6-minute walk test(6MWT),scores of Minnesota Living with Heart Failure Questionnaire(MLHFQ)and major adverse cardiovascular events(MACE,mortality and readmission rate for heart failure)were compared between 2 groups.Results After treatment for 24 weeks,clinical effective rate was significantly higher in observation group(85.1%)than that in control group(64.6%,P<0.05).In observation group,NT-proBNP,hs-cTnT,left ventricular end-diastolic inner diameter(LVEDD),left ventricular end-systolic diameter(LVESD)and MLHFQ decreased,and LVEF,cardiac index(CI)and 6MWT increased after treatment(all P<0.05).After treatment for 24 weeks,hs-cTnT and MLHFQ decreased significantly,and LVEF,CI and 6MWT increased significantly in observation group compared with control group(all P<0.05).The readmission rate for HF was lower in observation group(12 cases,25.5%)than that in control group(22 cases,45.8%,P<0.05),and there was no cardiac death case in 2 groups.Conclusion Sakubatril/valsartan is safe and effective in treating HFrEF patients,and can significantly improve exercise tolerance and left ventricular function,and reduce hs-cTnT level and readmission rate for HF compared with benazepril.
作者
郑冠群
盛晓东
Zheng Guanqun;Sheng Xiaodong(Department of Cardiovascular Medicine,Changshu Hospital,Xuzhou Medical University,Changshu 215500,China;不详)
出处
《中国循证心血管医学杂志》
2021年第10期1210-1213,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
江苏省常熟市卫计委科技计划项目(csws201810)。
