摘要
目的评估沙库巴曲缬沙坦钠对老年慢性心力衰竭(心衰)合并肾功能不全患者的疗效和对肾功能的影响,为该药的使用提供临床参考.方法选取2018年4月至2019年3月天津市红桥医院心血管内科收治的老年慢性心衰合并肾功能不全患者96例,按用药不同分为沙库巴曲缬沙坦钠组和贝那普利组.两组患者均给予了规范抗心衰治疗,并分别给予了沙库巴曲缬沙坦钠或贝那普利口服,两组均连续治疗24周后评价疗效.比较治疗前后两组患者的临床疗效和左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、血浆N末端脑钠肽前体(NT-proBNP)及肌酐清除率(CCr)的变化.结果沙库巴曲缬沙坦钠组总有效率明显高于贝那普利组〔97.92%(47/48)比85.42%(41/48),P<0.05〕.治疗后两组LVEF、LVEDD和NT-proBNP水平均较治疗前明显改善,沙库巴曲缬沙坦钠组治疗后上述指标改善情况均明显优于贝那普利组〔LVEF:0.41±0.06比0.36±0.05,LVEDD(mm):52±6比56±4,NT-proBNP(ng/L):864.52±179.51比1366.85±221.73,均P<0.05〕.治疗后两组CCr均较治疗前降低,仅贝那普利组差异有统计学意义(mL/min:44.9±29.2比66.7±31.6,P=0.0472),且贝那普利组CCr明显低于沙库巴曲缬沙坦钠组(mL/min:44.9±29.2比57.6±19.3,P<0.05).结论沙库巴曲缬沙坦钠对老年慢性心衰合并肾功能不全患者的疗效明显优于贝那普利,且同时具有肾保护作用,老年患者可安全使用.
Objective To evaluate the curative effect of Sacubitril Valsartan Sodium Tablet in elderly patients with chronic congestive heart failure combined with renal insufficiency and its effect on renal functions,so as to provide clinical references for usage of this medicine.Methods Ninety-six elderly patients with chronic congestive heart failure complicated with renal dysfunction in Tianjin Hongqiao Hospital from April 2018 to March 2019 were selected and divided into two groups(Sacubitril Valsartan Sodium group and Benazepril group)according to different medication plans.The patients in two groups were given standard anti heart failure treatment,and were orally given Sacubitril Valsartan Sodium and Benazepril respectively.After 24 weeks of continuous treatments,the clinical effects were evaluated.The changes of clinical effect,left ventricular ejection fraction(LVEF),left ventricular end-diastolic internal diameter(LVEDD),plasmatic N-terminal pro brain natriuretic peptide(NT-proBNP)and creatinine clearance(CCr)were compared between the two groups before and after treatments.Results The total efficiency rate of Sacubitril Valsartan Sodium group was obviously higher than that in Benazepril group[97.92%(47/48)vs.85.42%(41/48),P<0.05].After treatment,LVEF,LVEDD and NT-proBNP levels in two groups after treatment were significantly improved compared with those before treatment,and the improvement of above indexes in Sacubitril Valsartan Sodium group was significantly better than that in Benazepril group[LVEF:0.41±0.06 vs.0.36±0.05,LVEDD(mm):52±6 vs.56±4,NT-proBNP(ng/L):864.52±179.51 vs.1366.85±221.73,all P<0.05].After treatment,CCr levels in two groups were lower than those before treatment,and the difference was statistically significant only in Benazepril group(mL/min:44.9±29.2 vs.66.7±31.6,P=0.0472),and the CCr of Benazepril group was significantly lower than that of Sacubitril Valsartan Sodium group(mL/min:44.9±29.2 vs.57.6±19.3,P<0.05).Conclusion Sacubitril Valsartan Sodium is more clinically effective than Benazepril in elderly patients with chronic heart failure complicated with renal insufficiency,and it is potentially protective on renal function,which is safe for elderly patients.
作者
董萌
Dong Meng(Department of Cardiology,Tianjin Hongqiao Hospital,Tianjin 300131,China)
出处
《中国中西医结合急救杂志》
CAS
CSCD
北大核心
2020年第1期84-87,共4页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
天津市科技计划项目(16ZXMJSY00150)。
关键词
老年
慢性心力衰竭
肾功能不全
沙库巴曲缬沙坦钠
贝那普利
肌酐清除率
Elderly
Chronic heart failure
Renal insufficiency
Sacubitril Valsartan Sodium Tablets
Benazepril
Creatinine clearance
