摘要
探究沙库巴曲缬沙坦联合米力农治疗慢性心力衰竭(CHF)合并肺动脉高压(PH)对肺动脉压(sPAP)及血清N末端脑钠肽前体(NT-proBNP)、可溶性生长刺激表达基因2蛋白(sST2)的影响。选取400例2022年1月—2023年12月本院收治的CHF合并PH患者,采取随机数字表法将其分为联合组(200例)和米力农组(200例)。米力农组使用米力农治疗,联合组在此基础上加用沙库巴曲缬沙坦治疗,两组均连续治疗3个月。观察两组疗效及治疗前后心功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)]、6 min步行距离(6MWD)、sPAP、炎症因子[白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平、血清NT-proBNP、sST2水平以及治疗期间不良反应发生情况。治疗后,相较于米力农组的79.00%,联合组治疗总有效率(90.00%)更高(P<0.05);相较于米力农组的LVEF(44.32%±7.56%)、6MWD(305.17±37.25)m,治疗后联合组的LVEF(51.17%±9.24%)水平更高、6MWD(329.94±48.83)m更长(P<0.05);相较于米力农组的LVEDD(52.68±4.17)mm、sPAP(48.36±7.26)mmHg、血清NT-proBNP(988.35±192.20)pg/mL、sST2(85.64±11.36)ng/mL、IL-6(20.19±2.44)ng/L和TNF-α(34.35±3.38)ng/L,联合组的LVEDD(48.38±4.32)mm、sPAP(40.15±9.63)mmHg及血清NT-proBNP(765.59±123.60)pg/mL、sST2(58.35±9.75)ng/mL、IL-6(18.27±2.54)ng/L和TNF-α(30.42±3.26)ng/L水平更低(P<0.05)。治疗期间,两组的不良反应发生率分别为5.00%和9.00%,相比无统计学意义(P>0.05)。沙库巴曲缬沙坦联合米力农治疗CHF合并PH疗效良好,有利于患者心功能恢复,降低sPAP,减轻心力衰竭程度,抑制炎症反应,安全性良好,值得在临床推广应用。
To explore the effects of sacubitril valsartan combined with milrinone on systolic pulmonary artery pressure(sPAP),serum N-terminal brain natriuretic peptide precursor(NT-proBNP)and soluble growth stimulating express gene 2(sST2)in chronic heart failure(CHF)combined with pulmonary hypertension(PH),according to random number table method,400 patients with CHF and PH in the hospital were enrolled and divided into milrinone group(200 cases,milrinone)and combination group(200 cases,sacubitril valsartan combined with milrinone)between January 2022 and December 2023.All patients were treated for 3 months.The curative effect,cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)],6 min walking test distance(6MWD),sPAP,levels of inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],serum NT-proBNP and sST2 before and after treatment,and occurrence of adverse reactions during treatment in the two groups were observed.Compared with milrinone group after treatment,total response rate of treatment was higher in combination group(90.00%vs 79.00%,P<0.05),LVEF[(51.17%±9.24%)vs(44.32%±7.56%)]was higher,and 6MWD[(329.94±48.83)m vs(305.17±37.25)m]was longer(P<0.05).Compared with milrinone group,LVEDD[(48.38±4.32)mm vs(52.68±4.17 mm)],sPAP[(40.15±9.63)mmHg vs(48.36±7.26 mmHg)],serum NT-proBNP[(765.59±123.60)pg/mL vs(988.35±192.20)pg/mL],sST2[(58.35±9.75)ng/mL vs(85.64±11.36 ng/mL)],IL-6[(18.27±2.54)ng/L vs(20.19±2.44 ng/L)]and TNF-α[(30.42±3.26)ng/L vs(34.35±3.38)ng/L]were lower in combination group(P<0.05).During treatment,the incidence of adverse reactions in the two groups was similar(5.00%vs 9.00%,P>0.05).Curative effect of sacubitril valsartan combined with milrinone is good in patients with CHF and PH,which is beneficial to recover cardiac function,reduce sPAP,relieve heart failure and inhibit inflammatory response,with good safety,and is worthy of clinical promotion and application.
作者
赵婷
尹先东
汤克虎
ZHAO Ting;YIN Xiandong;TANG Kehu(Huairou Hospital,Beijing Chaoyang Hospital of Capital Medical University,Beijing 101400,China;Beijing Chaoyang Hospital of Capital Medical University,Beijing 100020,China)
出处
《药物生物技术》
2025年第3期337-341,共5页
Pharmaceutical Biotechnology
关键词
沙库巴曲缬沙坦
米力农
慢性心力衰竭
肺动脉高压
肺动脉压
N末端脑钠肽前体
可溶性生长刺激表达基因2蛋白
Sacubitril valsartan
Milrinone
Chronic heart failure
Pulmonary hypertension
Pulmonary artery pressure
N-terminal brain natriuretic peptide precursor
Soluble growth stimulating express gene 2
