摘要
目的对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、沙库巴曲缬沙坦单盲导入期后,进入双盲导入期:1:1随机分配,30例继续接受沙库巴曲缬沙坦为A组,30例用厄贝沙坦治疗为B组,随访6个月。对比分析两组患者治疗前后血浆末端B型利钠肽原(NT-proBNP)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、血清肌钙蛋白(cTnT)变化,计算对比治疗后的有效率、6个月再住院率、心源性死亡率、高血钾症发病率。结果两组患者治疗前LVEF、NT-proBNP的数值无明显差异(P>0.05),治疗后,A组患者NT-proBNP明显小于B组,A组患者LVEF明显高于B组,差异均具有统计学意义(P<0.05);A组患者总有效率83.33%明显高于B组60.00%,A组再住院率6.67%明显低于B组30.00%,差异均具有统计学意义(P<0.05),A组和B组治疗前后的LVEDD、cTnT数值、心源性死亡率、高血钾率均无明显差异(P>0.05)。结论沙库巴曲缬沙坦治疗心力衰竭效果优于厄贝沙坦,能起到改善心脏结构和功能的作用,能降低患者再入院率、减少治疗费用,值得临床推广。
Objective To compare the clinical effects of sacubitril valsartan and irbesartan in the treatment of chronic heart failure.Methods 60 patients with chronic heart failure(CHF)admitted to our hospital from July to December 2018 were selected.After the single-blind lead-in period of irbesartan and sacubitril valsartan,the patients enrolled in the double-blind lead-in period,and were randomly assigned to group A and group B in a 1:1 ratio.30 patients in group A continued to receive sacubitril valsartan,and 30 patients in group B were treated with irbesartan.Both groups were followed up for 6 months.The changes of plasma N-terminal pro-B-type natriuretic peptide(NT-proBNP),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)and serum cardiac troponin T(cTnT)before and after treatment of patients in the two groups were compared.The effective rate after treatment,6-month readmission rate,cardiogenic mortality and incidence of hyperkalemiawere calculated and compared.Results There were no significant differences in the values of LVEF and NT-proBNP before treatment between the two groups(P>0.05).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<0.05).The total effective rate of group A was 83.33%,which was significantly higher than that of group B(60.00%).The readmission rate of group A was 6.67%,which was obviously lower than that of group B(30.00%)with statistically significant difference(P<0.05).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>0.05).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.
作者
杨兆瑞
刘芳
宋敏青
YANG Zhaorui;LIU Fang;SONG Minqing(Department of Cardiovascular Medicine,Yichun People's Hospital in Jiangxi Province,Yichun336000,China)
出处
《中国现代医生》
2019年第36期44-47,共4页
China Modern Doctor
基金
江西省卫生计生委科技计划（20197484）
