摘要
目的 探讨沙库巴曲缬沙坦联合胺碘酮对老年心力衰竭合并持续性心房颤动患者血管内皮及心功能的影响。方法 选取义乌市中心医院2019年6月至2021年6月收治的188例老年心力衰竭合并持续性心房颤动患者为研究对象。按照治疗方法不同分成观察组(沙库巴曲缬沙坦联合胺碘酮治疗)、对照组(仅胺碘酮治疗),每组94例。比较两组患者总有效率、心率震荡指标(包括震荡初始值、震荡斜率、震荡时域分析指标)、血管内皮功能指标(包括血管内皮素-1、内皮源性一氧化氮)、心肌损伤指标(包括肌钙蛋白I、肌酸激酶同工酶、乳酸脱氢酶)、心功能指标[包括N末端脑钠肽前体(NT-proBNP)、Tei指数、左心室射血分数(LVEF)]、生命质量评分、肝肾功能指标(包括谷草转氨酶、谷丙转氨酶、尿素氮、血肌酐)等。结果 观察组总有效率明显高于对照组(P<0.05)。治疗前,两组患者心率震荡指标、血管内皮功能指标、心肌损伤指标、心功能指标、生命质量评分、肝肾功能指标比较,差异均无统计学意义(均P>0.05)。治疗后,两组患者心率震荡指标、内皮源性一氧化氮、LVEF均明显升高(均P<0.05),且观察组均明显高于对照组(均P<0.05);两组患者血管内皮素-1、心肌损伤指标、NT-proBNP、Tei指数、生命质量评分均明显降低(均P<0.05),且观察组明显低于对照组(均P<0.05);而肝肾功能指标比较差异均无统计学意义(均P>0.05)。结论 沙库巴曲缬沙坦联合胺碘酮对老年心力衰竭合并持续性心房颤动患者安全有效,可减轻心肌损伤,改善血管内皮功能和心功能,提升生命质量。
Objective To investigate the effects of sacubitril valsartan and amiodarone on vascular endothelial function and cardiac function in elderly patients with heart failure complicated with persistent atrial fibrillation. Methods A total of 188 elderly patients with heart failure complicated with persistent atrial fibrillation admitted in our hospital from June 2019 to June 2021 were selected. According to the treatments, the patients were randomly divided into observation group(treated with amiodarone plus sacubitril valsartan) and control group(treated with amiodarone only), 94 cases in each group. The total effective rate, heart rate turbulence indexes [including turbulence onset(TO), turbulence slope(TS), standard deviation of NN intervals(SDNN)], vascular endothelial function indexes(including endothelin-1,endothelium-derived nitric oxide), myocardial injury indexes[including cardiac troponin I(cTNI), creatine kinase MB isoenzyme(CK-MB), lactate dehydrogenase(LDH)], cardiac function indexes [including N-terminal pro-B-type natriuretic peptide(NT-proBNP), Tei index, left ventricular ejection fraction(LVEF)], quality of life score, liver and kidney function indexes(including aspartate tramsaminase AST, alanine transaminase ALT, blood urea nitrogen BUN, serum creatinine Scr) were compared between the two groups. Results The total effective rate of the observation group was higher than the control group(P<0.05). Before treatment, there was no significant differences in heart rate turbulence index, vascular endothelial function index, myocardial injury index, cardiac function index, quality of life score, and liver and kidney function index between the two groups(all P >0.05). After treatment, the heart rate turbulence index, the level of endothelial nitric oxide and the left ventricular ejection fraction were significantly improved in both groups(all P<0.05).The indexes in observation group were higher than those in the control group(all P<0.05). The level of endothelin-1,myocardial injury index, NT-proBNP level, Tei index, the quality of life score were significantly reduced in both groups(all P<0.05). And the indexes in observation group was lower than those in the control group(all P<0.05). While no significant differences were observed in liver and kidney function indexes between the two groups(all P >0.05). Conclusion The combination of sacubitril valsartan and amiodarone was safe and effective regimen for the elderly patients with heart failure complicated with persistent atrial fibrillation, with function of reducing myocardial injury,improving vascular endothelial function and cardiac function, improving quality of life.
作者
傅婷
徐磊
季宁宁
FU Ting;XU Lei;JI Ningning(Department of Cardiology,Yiwu Central Hospital,Yiwu 322000,China)
出处
《心电与循环》
2023年第1期26-30,36,共6页
Journal of Electrocardiology and Circulation
基金
金华市科学技术研究计划项目(2020-4-149)。
关键词
沙库巴曲缬沙坦
胺碘酮
心力衰竭
心房颤动
Sacubitril valsartan sodium
Amiodarone
Heart failure
Atrial fibrillation
