作者：彭凯歌，章礼玲，余慧琳

单位：

246003安徽省安庆市立医院心血管内科

Units：

Department of Cardiovascular Medicine, Anqing Municipal Hospital, Anqing 246003, China

关键词：

心力衰竭；射血分数；肥大，左心室；沙库巴曲缬沙坦；治疗结果

Keywords：

Heart failure; Ejection fraction; Hypertrophy, left ventricular; Sakubatrel valsartan; Treatment outcome

CLC：

R 541.6

DOI：

10.12114/j.issn.1008-5971.2022.00.236

Funds：

摘要：

目的　探讨沙库巴曲缬沙坦治疗射血分数＜45%的心力衰竭并左心室扩大患者的临床疗效。方法　选取2020年度安庆市立医院收治的射血分数＜45%的心力衰竭并左心室扩大患者80例为研究对象。采用信封法将其随机分为对照组和研究组，每组40例。对照组患者给予基础临床治疗方案，研究组患者在对照组基础上停用缬沙坦或贝那普利、卡托普利治疗，加用沙库巴曲缬沙坦。两组均持续治疗6个月。比较两组治疗后治疗效果，治疗前及治疗6个月后N末端脑钠肽前体（NT-proBNP）、6 min步行距离（6MWD）、左心室射血分数（LVEF）、左心室舒张末期内径（LVEDD），记录两组患者用药期间不良反应发生情况。结果　治疗后研究组总有效率为95.0%（38/40），高于对照组的77.5%（31/40）（χ2=5.165，P =0.023）。治疗后，两组NT-proBNP分别低于同组治疗前，6MWD分别长于同组治疗前，LVEF分别高于同组治疗前，LVEDD分别小于同组治疗前（P ＜0.05）；且研究组NT-proBNP低于对照组，6MWD长于对照组，LVEF高于对照组，LVEDD小于对照组（P ＜0.05）。研究组血管水肿、高钾血症发生率低于对照组（P ＜0.05）。结论　沙库巴曲缬沙坦可有效提高射血分数＜45%的心力衰竭并左心室扩大患者治疗效果，可改善患者心功能及抑制心室重构，减少不良反应，值得临床推广。

Abstract：

Objective　To investigate the efficacy of sakubatrel valsartan in the treatment of heart failure with ejectionfraction < 45% combined with left ventricular dilation. Methods　A total of 80 patients of heart failure with ejection fraction< 45% combined with left ventricular dilation in Anqing Municipal Hospital in 2020 were selected as the study subjects. Theywere divided into control group and research group by envelope method, 40 cases in each group. The control group was treatedwith basic clinical treatment plan, and the research group stopped the treatment of valsartan, benazepril and captopril, andwere added with sakubatrel valsartan on the basis of control group. Both groups were treated for 6 months. The clinical efficacyafter treatment, N-terminal pro-brain natriuretic peptide (NT-proBNP) , 6 minutes walking distance (6MWD) , left ventricularejection fraction (LVEF) and left ventricular end-diastolic dimension (LVEDD) before treatment and after treatment of the twogroups were compared. The adverse reactions of the two groups were recorded. Results　After treatment, the total effective rateof the research group [95.0% (38/40) ] was higher than that [77.5% (31/40) ] of the control group (χ2=5.165, P =0.023) . The NTproBNPafter treatment in the control group and the research group was lower than that before treatment, 6MWD after treatmentin the control group and the research group was longer than that before treatment, LVEF after treatment in the control group andthe research group was higher than that before treatment, LVEDD after treatment in the control group and the research group wassmaller than that before treatment, respectively (P < 0.05) . After treatment, NT-proBNP in the research group was lower thanthat in the control group, 6MWD in the research group was longer than that in the control group, LVEF in the research group washigher than that in the control group, LVEDD in the research group was smaller than that in the control group (P < 0.05) . Theincidence of angioedema and hyperkalemia in the research group was lower than that in the control group (P < 0.05) . Conclusion　Sakubatrel valsartan can significantly improve the therapeutic effect of heart failure with ejection fraction < 45% combined withleft ventricular dilation, improve cardiac function, inhibition of ventricular remodeling, and reduce adverse reactions, worthy ofclinical promotion.

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