沙库巴曲缬沙坦钠在射血分数降低的心力衰竭患者的临床研究

摘要 目的：观察沙库巴曲缬沙坦钠治疗射血分数降低的心力衰竭(heart failure with reduced ejection fraction，HFrEF)患者的效果。方法：选取2018年1月-2018年12月内蒙古自治区人民医院心脏中心心血管内科收治的90例HFrEF患者，随机分为观察组和对照组，每组45例。对照组患者常规抗心衰治疗，其中血管紧张素转换酶抑制剂（angiotensin converting enzyme inhibitor，ACEI）为盐酸贝那普利；观察组患者将常规抗心衰治疗中的ACEI替换为沙库巴曲缬沙坦钠，两组患者均治疗1月。比较两组患者治疗的总有效率、血浆N端前脑钠肽（N-terminal pro-B-type natriaretic peptide，NT-proBNP）、血浆肌钙蛋白T（cardiac troponin T，cTnT）、肌酸激酶同工酶（creatine kinase isoenzymes，CK-MB）、左室舒张末期内径（left ventricular end-diastolic diameter，LVEDD）、左室收缩末期内径（left ventricular end systolic diameter，LVESD）、左室射血分数（left ventricular ejection fraction，LVEF）、6分钟步行距离（6 minutes walking distance，6MWD）及不良反应。结果：观察组患者临床疗效优于对照组（P<0.05），NT-proBNP、cTnT、LVEDD和LVESD较对照组明显降低（P<0.05），LVEF和6MWD 较对照组明显增加（P<0.05）；对照组血肌酐水平显著高于观察组（P<0.05）。结论：沙库巴曲缬沙坦钠治疗HFrEF临床疗效好，能有效改善心功能。

Observation on the Effect of Sacubitril Valsartan in Patients with Heart Failure with Reduced Ejection Fraction

ABSTRACT Objective: To observe the effect of Sacubitril valsartan in treating HFrEF. Methods: From January 2018 to December 2018, 90 patients from the Cardiovascular Medicine Department of Inner Mongolia People''s Hospital were selected as the subjects, random divided into the observation group and the control group, each group of 45 patients. Conventional anti-heart failure treatment in control group, among them, the ACEI was Benazepril hydrochloride. The observation group, ACEI was replaced by Sacubitril valsartan in routine anti-heart failure treatment, the two groups were treated for 1 month. The total efficiency, NT-proBNP, cTnT, CK-MB, LVEDD, LVESD, LVEF, 6MWD and adverse reactions were compared between the two groups. Results: The clinical effect of the observation group was better than that of the control group (P<0.05). The NT-proBNP, cTnT, LVEDD and LVESD in the observation group were significantly lower than in the control group, 6MWD and LVEF were significantly increased compared to the control group (P<0.05). The increased blood creatinine level in the control group was significantly higher than that the observation group (P<0.05). Conclusion: Sacubitril valsartan had a good clinical effect in treating heart failure with reduced ejection fraction and could effectively improve cardiac function.