摘要
目的探讨沙库巴曲缬沙坦(ARNI)治疗心力衰竭患者的疗效和安全性。方法将射血分数降低(EF≤40%)的心力衰竭患者随机分为ANRI组和对照组,ANRI组口服ANRI,对照组予以常规改善心功能药物治疗;所有入组患者实验开始前完善6min步行试验(6MWT)、肝肾功能电解质、氨基末端脑钠肽原(NTPro-BNP)、胸片、心脏超声检查,以后连续随访6个月、定期评估心功能分级改善、心律失常发生以及因心衰再次住院情况。结果共纳入80例射血分数降低(EF≤40%)心力衰竭患者(ANRI组35例,对照组45例),平均随访时间(6+0.8)个月,ARNI组患者左房直径(LAD)、左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)数值均较对照组缩小,左室射血分数较对照组升高,差异有统计学意义;6MWT比较中,ANRI组较对照组测试距离明显增加(P=0.012);随访6个月内均有新发心律失常事件,口服ARNI治疗后期心律失常事件显著减少,CRT-D、ICD患者误放电事件减少;ARNI组6个月内因心衰再次入院率较对照组低(P=0.030)。结论ANRI能有效改善心力衰竭患者心功能,提高心力衰竭患者生活质量,减少因心力衰竭再次住院率。
Objective To investigate the efficacy and safety of sacubitril/valsartan(ARNI)in the treatment of heart failure patients.Methods Patients in heart failure with reduced ejection fraction(EF≤40%)were randomly divided into the ANRI group and control group,patients in ANRI group took the medicine of sacubitril/valsartan(p.o),patients in control group were treated with regular management to improve the cardiac function 6-min-walk test(6 MWT),liver and kidney function,electrolyte,amino-terminal brain natriuretic peptide(NTPro-BNP),chest radiography and echocardiography were running within a continuous follow-up of 6 months,cardiac function improvement,arrhythmias and rehospitalization rates due to heart failure were regularly evaluated.Results 80 heart failure patients(35 patients in ANRI group,45 patients in control group)with reduced ejection fraction were enrolled in our study,the mean follow-up was 6±0.8 months.The LAD(left atrial diameter),LVEDD(left ventricular end diastolic diameter),LVESD(left ventricular end systolic diameter)of the patients in ARNI group were more reduced than those in the control group,the improvement of left ventricular ejection fraction in ARNI group was higher than that of the control group.The difference was stistically significant.6MWT in ANRI group was resulted significantly increased compared with the control group(P=0.012).There were new arrhythmias within 6 months in both groups,Arrhythmias significantly decreased at the later stage of ARNI therapy,and more false shock events reduced in patients with CRT-D(cardiac resynchronization therapy wit defirillator),ICD(implantable cardioverter defibillator)device.The readmission rate of heart failure in ARNI group was lower(P=0.030).Conclusion ANRI can fectively improve the cardiac function,quaity of life in heart failure patients with reduced ejection fraction and reduced recurrence rate of hospitalization caused by heart failure.
出处
《浙江临床医学》
2020年第12期1776-1778,共3页
Zhejiang Clinical Medical Journal
基金
浙江省绍兴市柯桥区社发类科技计划项目(2018KZ36)。
