摘要
目的观察沙库巴曲缬沙坦治疗老年慢性心力衰竭(CHF)的临床效果。方法选取2021年5月—2023年5月长沙市第九医院收治的老年CHF患者60例,按入院先后顺序分为常规治疗组与联合治疗组,各30例。常规治疗组予以常规综合治疗,联合治疗组在常规治疗组基础上予以沙库巴曲缬沙坦。2组均持续用药8周。比较2组临床疗效,用药前后心功能指标[左室射血分数(LVEF)、心脏指数(CI)、左室质量指数(LVMI)、左室射血期峰值流率(FRPE)、射血—充盈血流逆转流率(FRR)]、6 min步行距离(6MWD)、实验室指标[血清N末端脑钠肽前体(NT-proBNP)、可溶性基质裂解素2(sST2)、血管紧张素Ⅱ(AngⅡ)、半乳糖凝聚素3(Gal-3)、脂联素(ANP)、基质金属蛋白酶-9(MMP-9)],不良反应。结果联合治疗组治疗总有效率高于常规治疗组(93.33%vs.73.33%,χ^(2)=4.320,P=0.038)。用药8周后,2组LVEF、CI、FRPE、FRR升高,LVMI降低,6MWD延长,且联合治疗组改善幅度大于常规治疗组(P<0.01);2组血清NT-proBNP、sST2、AngⅡ、Gal-3、ANP、MMP-9水平降低,且联合治疗组低于常规治疗组(P<0.01)。联合治疗组不良反应总发生率与常规治疗组比较,差异无统计学意义(16.67%vs.10.00%,χ^(2)=0.577,P=0.448)。结论老年CHF患者应用沙库巴曲缬沙坦治疗,可以改善心肌重构和临床症状,促进患者心功能恢复,提高运动耐量,且安全性较高。
Objective To observe the clinical effect of sacubitril valsartan in the treatment of elderly patients with CHF.Methods A total of 60 elderly CHF patients admitted to the Ninth Hospital of Changsha from May 2021 to May 2023 were selected,and they were divided into the conventional treatment group and the combined treatment group according to the order of admission,with 30 patients in each group.Patients in the conventional treatment group were received routine complex treatment,while patients in the combined treatment group were received sacubitril valsartan on the basis of the conventional treatment group.Both groups were treated continuously for 8 weeks.Clinical efficacy,cardiac function indicators(LVEF,CI,LVMI,FRPE,FRR),6MWD,laboratory indicators(NT-proBNP,sST2,AngⅡ,Gal-3,ANP,MMP-9)before and after treatment,and adverse reactions were compared between the two groups.Results The total effective rate of the combined treatment group was higher than that of the conventional treatment group(93.33%vs.73.33%,χ^(2)=4.320,P=0.038).After 8 weeks of treatment,the two groups showed increased LVEF,CI,FRPE,and FRR,decreased LVMI,and prolonged 6MWD,with the combined treatment group showed greater improvement than those in the conventional treatment group(P<0.01).Levels of serum NT-proBNP,sST2,AngⅡ,Gal-3,ANP,and MMP-9 decreased in the two groups,and the combined treatment group had lower levels than those in the conventional treatment group(P<0.01).There was no statistically significant difference in the total incidence of adverse reactions between the combined treatment group and the conventional treatment group(16.67%vs.10.00%,χ^(2)=0.577,P=0.448).Conclusion The application of sacubitril valsartan in the elderly patients with CHF can improve myocardial remodeling and clinical symptoms,promote cardiac function recovery,enhance exercise tolerance,and with high safety.
作者
刘顺林
胡章勇
LIU Shunlin;HU Zhangyong(The Ninth Hospital of Changsha,Changsha 410000,China)
出处
《临床合理用药杂志》
2024年第30期5-8,共4页
Chinese Journal of Clinical Rational Drug Use
基金
长沙市科技计划项目(YNKY202216)。
关键词
慢性心力衰竭
老年人
沙库巴曲缬沙坦
常规治疗
心功能
运动耐量
治疗结果
Chronic heart failure
Elderly
Sacubitril valsartan
Conventional therapy
Cardiac function
Exercise tolerance
Treatment outcome
