小劑量沙庫巴曲纈沙坦在心力衰竭患者中的療效分析

倪秋明　　林苗　　李偉信　　王軍

[關鍵詞] 小劑量，沙庫巴曲纈沙坦;培哚普利;心力衰竭;療效

[中圖分類號] R541.6? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 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，幾乎所有的心血管疾病如高血壓、急性心肌梗死、心肌病、炎癥、血流動力學負荷過重均可導致心力衰竭，其具有發病率高、死亡率高、再住院率高等特點，日益成為嚴重威脅人類健康重要問題之一。目前心力衰竭仍以藥物治療為主要手段，隨著對心力衰竭認識的不斷深入，治療理念已從既往的糾正血流動力學紊亂轉變為抑制神經內分泌系統的過度激活，改善心肌重構，提高生活質量，降低遠期死亡率[1]。目前血管緊張素轉化酶抑制劑（Angiotensin-converting enzyme inhibitor，ACEI）/血管緊張素受體拮抗劑（Angiotensin receptor blocker，ARB）、β受體阻滯劑和醛固酮受體拮抗劑作為能改善長期預后的藥物應該應用到每一例射血分數降低的心力衰竭患者的治療中[2]。而最新的《中國心力衰竭診斷和治療指南2018》推薦血管緊張素受體和腦啡肽酶抑制劑（Angiotension receptor and enkephalinase inhibitor，ARNI類）在紐約心功能Ⅱ～Ⅲ級，如能耐受ACEI或ARB，以ARNI替代ACEI/ARB，可進一步降低心力衰竭的發病率和病死率[3]。小劑量沙庫巴曲纈沙坦與足劑量培哚普利心力衰竭對比的研究尚不多，本研究旨在比較小劑量沙庫巴曲纈沙坦與足劑量培哚普利在心力衰竭患者中的療效和副作用，現報道如下。