摘要
目的 观察沙库巴曲缬沙坦钠片对慢性心力衰竭患者心室重构及血浆微小RNA-423-5p(micrornA-423-5p,miR-423-5p)、可溶性基质裂解素2(soluble stroma-lysin 2,sST2)的影响。方法 选择于医院治疗的112例慢性心力衰竭患者,治疗时间为2021年5月—2022年5月,根据随机数字表法分组,56例患者为单一治疗组,给予基础治疗,56例患者为联合治疗组,在单一治疗组基础上给予患者沙库巴曲缬沙坦钠片治疗,治疗前、后检测2组患半乳糖凝集素3(galactolectin 3,Gal-3)、血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)、可溶性基质裂解素2(soluble stroma-lysin 2,sST2)、基质金属蛋白酶9(matrix metalloproteinase-9,MMP-9)、五聚体蛋白-3(pentameter protein-3,PTX-3)、谷胱甘肽过氧化物酶3(glutathione peroxidase 3,GPX-3)、嗜铬粒蛋白A(chromogranin A,CgA)、总抗氧化能力(total antioxidant capacity,T-AOC)、miR-423-5p、丙二醛(malonaldehyde,MDA)、左心室射血分数(left ventricular ejection fraction,LVEF)、左心室舒张期平均能量损耗(left ventricular average diastolic energy loss,EL-ave)、左心室心肌质量指数(life ventricular myocardial mass index,LVMI)水平,治疗前、后给予患者6 min步行距离(6 min walking distance,6MWT)、明尼苏达心衰生活质量量表评分(minnesota Heart Failure Quality of Life Scale score,MLHFQ)评价,比较单一治疗组及联合治疗组临床疗效。结果 联合治疗组MDA含量较单一治疗组明显低(P<0.05),联合治疗组GPX-3、T-AOC含量较单一治疗组明显高(P<0.05);联合治疗组Gal-3、miR-423-5p、sST2、CgA含量较单一治疗组明显低(P<0.05);联合治疗组MMP-9、AngⅡ、PTX-3含量较单一治疗组低(P<0.05);联合治疗组LVEF、EL-ave较单一治疗组高(P<0.05),联合治疗组LVMI较单一治疗组低(P<0.05);联合治疗组MLHFQ评分较单一治疗组低(P<0.05),联合治疗组6MWT较单一治疗组多(P<0.05);联合治疗组总有效率(98.21%)较单一治疗组明显高(89.29%)(P<0.05)。结论 沙库巴曲缬沙坦治疗慢性心力衰竭患者,可减少氧化应激及心肌纤维化损伤,改善心室重构及心功能,提升患者生活质量、活动耐力及临床疗效。
Objective To observe the effects of Sacubitril Valsartan Sodium Tablets on ventricular remodeling,plasma micrornA-423-5p(miR-423-5p) and soluble stroma-lysin 2(sST2) in patients with chronic heart failure(CHF).Methods A total of 112 patients with CHF who were treated in hospital from May 2021 to May 2022 were grouped according to the random number table method.Fifty-six patients in the single treatment group received basic treatment,and 56 patients in the combination treatment group received Sacubitril Valsartan Sodium Tablets on the basis of single treatment group.Galactolectin 3(Gal-3),angiotensin Ⅱ(AngⅡ),soluble stroma-lysin 2(sST2),matrix metalloproteinase-9(MMP-9),pentameter protein-3(PTX-3),glutathione peroxidase 3(GPX-3),chromogranin A(CgA),total antioxidant capacity(T-AOC),miR-423-5p,malonaldehyde(MDA),left ventricular ejection fraction(LVEF),left ventricle average energy loss(EL-ave),left ventricular myocardial mass index(LVMI) level,6 min walking test(6MWT) and Minnesota Living with Heart Failure Questionnaire score(MLHFQ) were detected before and after treatment.Clinical efficacy of the single treatment group and the combination treatment group were compared.Results MDA level in combination treatment group was significantly lower than that in single treatment group(P<0.05),while GPX-3 and T-AOC levels in combination treatment group were significantly higher than that in single treatment group(P<0.05).The levels of Gal-3,miR-423-5p,sST2 and CgA in combination treatment group were significantly lower than those in single treatment group(P<0.05),and the levels of MMP-9,AngⅡ and PTX-3 in combination treatment group were lower than those in single treatment group(P<0.05).The LVEF and EL-ave of the combination treatment group were higher than those of the single treatment group(P<0.05),while the LVMI of the combination treatment group was lower than that of the single treatment group(P<0.05).The MLHFQ score of the combination treatment group was lower than that of the single treatment group(P<0.05),while the 6MWT of the combination treatment group was higher than that of the single treatment group(P<0.05).The total effective rate of the combination treatment group(98.21%) was significantly higher than that of the single treatment group(89.29%)(P<0.05).Conclusion In the treatment of CHF patients,Sacubitril Valsartan Sodium Tablets can reduce oxidative stress and myocardial fibrosis damage,improve ventricular remodeling and cardiac function,and enhance patients′ quality of life,activity endurance and clinical efficacy.
作者
黄栢权
钟丁亮
杨亦炳
HUANG Bai-quan;ZHONG Ding-liang;YANG Yi-bing(Department of Pharmacy,Zhujiang Hospital,Southern Medical University,Guangzhou,Guangdong 510000,China)
出处
《河北医科大学学报》
CAS
2024年第1期70-75,共6页
Journal of Hebei Medical University
基金
广东省科技计划项目(2021B021800156)。
关键词
心力衰竭
沙库巴曲缬沙坦钠片
心室重构
heart failure
Sacubitril Valsartan Sodium Tablets
ventricular remodeling
