沙库巴曲缬沙坦与厄贝沙坦治疗心力衰竭的对比研究.doc

沙库巴曲缬沙坦与厄贝沙坦治疗心力衰竭的对比研究
[摘要] 目的 對比沙库巴曲缬沙坦和厄贝沙坦治疗慢性心力衰竭的临床效果。 方法 选取2018年7~12月我院收治的60例慢性心力衰竭(CHF)患者,首先经过厄贝沙坦、沙库巴曲缬沙ults There were no significant differences in the values of LVEF and NT-proBNP before treatment between the two groups(P>). After treatment, the NT-proBNP of patients in group A was significantly lower than that of patients in group B, and the LVEF of patients in group A was significantly higher than that of patients in group B. The differences were statistically significant(P<). The total effective rate of group A was %, which was significantly higher than that of group B(%). The readmission rate of group A was %, which was obviously lower than that of group B(%) with statistically significant difference(P<). There were no significant differences in LVEDD, cTnT values, cardiogenic mortality and incidence of hyperkalemia before and after treatment in group A and group B(P>). Conclusion Sacubitril valsartan is better than irbesartan in the treatment of heart failure, which can improve the structure and function of the heart, decrease the readmission rate and reduce the cost of treatment. Therefore, it is worthy of clinical promotion. [Key words] Valsartan mixture; Angiotensin Ⅱ type 1 receptor blocker; Heart failure; Natriuretic peptide
慢性心力衰竭(chronic heart failure,CHF)是机体在炎症、心肌病、血流动力改变等诱因下发生的心肌不可逆损伤,症状包括乏力、呼吸困难等,治疗CHF的主要措施已经从逐渐强心利尿的短期对症治疗转化为病因治疗如抑制神经-内分泌系统达到长期控制,临床常使用缬沙坦、厄贝沙坦等血管紧张素受体Ⅱ拮抗剂类药物降低致死率和防止心肌重塑[1]。沙库巴曲缬沙坦是一种新型合剂,在缬沙坦的基础上添加脑啡肽酶(neprilysin,NEPI)抑制剂,能舒张血管、排钠利尿和改善心血管重构,NEPI与利钠肽降解有关,其活性受抑制可能影响利钠肽水平,虽然既往研究中表明该药收到了一定的疗效[2],但常规剂量无统一规定且与单一药物应用比较研究较少,本文对比沙库巴曲缬沙坦和厄贝沙坦治疗CHF的临床效果,具体报道如下。
1 资料与方法
一般资料
选择2018年7~12月我院收治的60例慢性心力衰竭(CHF)患者,全部接续经过厄贝沙坦单盲导入期、洗脱期、沙库巴曲缬沙坦单盲导入期后,再次洗脱后,进入双盲期,1:1随机分为两组,每组30例,一组继续接受沙库巴曲缬沙坦治疗为A组,另一组仅接受厄贝沙坦治疗为B组。
其中A组男13例,女17例,年龄20~80岁,平均(±)岁;B组男15例,女15例,年龄20~80岁,平均(±)岁。纳入标准:(1)病史大于半年,年龄≥18岁,≤85岁;(2)符合CHF诊断标准[3];(3)纽约心功能分级属于Ⅱ~Ⅳ级;(4)左心室射血分数(LVEF)≤35%;(5)血浆末端