小剂量沙库巴曲缬沙坦在心力衰竭患者中的疗效分析

倪秋明　　林苗　　李伟信　　王军

[关键词] 小剂量，沙库巴曲缬沙坦;培哚普利;心力衰竭;疗效

[中图分类号] R541.6          [文献标识码] B          [文章编号] 1673-9701（2021）20-0043-04

Effect analysis of small dose sacubitri valsartan with heart failure

NI Qiuming    LIN Miao   LI Weixin   WANG Jun

Department of Cardiovascular Medicine，Wenzhou Central Hospital in Zhejiang Province，Wenzhou   325000，China

[Abstract] Objective To investigate the efficacy and safety of low-dose sacubitri valsartan in patients with heart failure. Methods A total of 160 outpatient and inpatient heat failure patients in our hospital from November 2018 to June 2019 were selected and divided into observation group and control group according to random number table method，with 80 patients in each group.The observation group was given low-dose sacubitri valsartan on the basis of conventional drug treatment，while the control group was given full dose perindopril for treatment，with a course of 6 months.Symptom improvement，NT-probNP，LVEF，LVEDD，LVESD，6MWD，QOLS and side effects were compared between the two patients before and after treatment. Results There were on significant differences in general data results， NT- ProBNP，LVEDD，LVESD，LVEF，6 MWDS or QOLS before the treatment （P>0.05）. Six months after treatment， the treatment effect rate of the observation group was higher than that of the observation group （P<0.05）， while the NT-ProBNP and QOLS in the observation group were lower than those of the control group （P<0.05）. The LVEDD and LVESD of two groups after treatment was significantly lower than that before treatment （P<0.05）. After treatment，the difference between groups had no statistical significance （P>0.05）. However，the LVEF of the observation group was higher than that in the control group （P<0.05）. There were no statistically significant differences in the incidences of hyperkalemia，hypotension and angioedema between the two groups （P>0.05）. The incidence of dry cough in the observation group was lower than that in the control group （P<0.05）. Conclusion Small dose of sacubitri valsartan is effective in heart failure and has few side effects.

[Key words] Small dose; Sacubitri valsartan; Perindopril; Heart failure; Effect

心力衰竭是最常見的心血管疾病之一，几乎所有的心血管疾病如高血压、急性心肌梗死、心肌病、炎症、血流动力学负荷过重均可导致心力衰竭，其具有发病率高、死亡率高、再住院率高等特点，日益成为严重威胁人类健康重要问题之一。目前心力衰竭仍以药物治疗为主要手段，随着对心力衰竭认识的不断深入，治疗理念已从既往的纠正血流动力学紊乱转变为抑制神经内分泌系统的过度激活，改善心肌重构，提高生活质量，降低远期死亡率[1]。目前血管紧张素转化酶抑制剂（Angiotensin-converting enzyme inhibitor，ACEI）/血管紧张素受体拮抗剂（Angiotensin receptor blocker，ARB）、β受体阻滞剂和醛固酮受体拮抗剂作为能改善长期预后的药物应该应用到每一例射血分数降低的心力衰竭患者的治疗中[2]。而最新的《中国心力衰竭诊断和治疗指南2018》推荐血管紧张素受体和脑啡肽酶抑制剂（Angiotension receptor and enkephalinase inhibitor，ARNI类）在纽约心功能Ⅱ～Ⅲ级，如能耐受ACEI或ARB，以ARNI替代ACEI/ARB，可进一步降低心力衰竭的发病率和病死率[3]。小剂量沙库巴曲缬沙坦与足剂量培哚普利心力衰竭对比的研究尚不多，本研究旨在比较小剂量沙库巴曲缬沙坦与足剂量培哚普利在心力衰竭患者中的疗效和副作用，现报道如下。