摘要
目的:分析不同剂量沙库巴曲缬沙坦钠治疗慢性心衰的临床效果。方法:选取2024年2月至2025年2月我院慢性心衰患者144例,按照药物剂量分为低剂量组、中剂量组、高剂量组(n=48),分别口服沙库巴曲缬沙坦钠50 mg Bid、100 mg Bid、200 mg Bid治疗。治疗3 m后,以彩色超声诊断仪检测左心室射血分数(Left ventricular ejection fraction,LVEF)、左心室舒张末期内径(Left ventricular end-diastolic diameter,LVEDD)、左心室收缩末期内径(Left ventricular end-systolic diameter,LVESD)水平;以黄嘌呤氧化酶法检测超氧化物歧化酶(Superoxide dismutase,SOD),硝酸还原酶法测定一氧化氮(Nitric oxide,NO)水平,硫代巴比妥酸法检测丙二醛(Malondialdehyde,MDA);治疗3 m后,以酶联免疫吸附法测定白细胞介素-6(Interleukin-6,IL-6)、超敏C反应蛋白(High-sensitivity C reactive protein,hs-CRP)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α);治疗3 m后,记录6 min步行距离(6 min walking test,6MWT);以明尼苏达州心力衰竭生活质量问卷(Minnesota living with heart failure questionnaire,MLHFQ)评估生活质量;比较三组不良反应。结果:高剂量组治疗效率为91.67%,高于低剂量组62.50%、中剂量组75.00%(P<0.05),且有剂量依赖性;用药后,高剂量组LVEF、LVEDD、LVESD、SOD、NO、MDA、IL-6、hs-CRP、TNF-α、6MWT、MLHFQ评分均优于低剂量组、中剂量组(P<0.05);高剂量组不良反应发生率为12.50%,与低剂量组4.17%、中剂量组8.33%比较无显著差异(P>0.05)。结论:慢性心衰应用高剂量沙库巴曲缬沙坦钠疗效显著,可改善心功能、炎性因子、生活质量指标。
Objective:To analyze the clinical effects of different doses of sacubitril valsartan sodium in the treatment of chronic heart failure.Methods:A total of 144 patients with chronic heart failure in our hospital were selected from February 2024 to February 2025,and were divided into low-dose group,medium-dose group,and high-dose group(n=48)according to the drug dose,and were treated with sacubitril valsartan sodium 50 mg Bid,100 mg Bid,and 200 mg Bid by oral administration,respectively.After 3 months of treatment,left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVEDD),and left ventricular end-systolic diameter(LVEDD)were detected by color ultrasound diagnostic instrument,Malondialdehyde(MDA)was measured by enzyme-linked immunosorbent assay(ELISA),interleukin-6(IL-6),high-sensitivity C reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)were measured by ELISA.After 3 months of treatment,6 min walking test(6MWT)was recorded,the quality of life was assessed by Minnesota living with heart failure questionnaire(MLHFQ),and adverse effects were recorded.Results:The therapeutic efficiency of the high-dose group was 91.67%,which was higher than 62.50%in the low-dose group and 75.00%in the medium-dose group(P<0.05),and there was a dose-dependence.After the administration of the drug,the scores of LVEF,LVEDD,LVESD,SOD,NO,MDA,IL-6,hs-CRP,TNF-α,6MWT,and MLHFQ of the high-dose group were better than those of the low-dose group and medium-dose group(P<0.05).The incidence of adverse reactions in the high-dose group was 12.50%,which was not significantly different from 4.17%in the low-dose group and 8.33%in the medium-dose group(P>0.05).Conclusion:The efficacy of applying high-dose sacubitril valsartan sodium in chronic heart failure is remarkable,which can improve cardiac function,inflammatory factors,and quality of life indicators.
作者
郭梦雪
李志英
Guo Meng-xue;Li Zhi-ying(Department of Pharmacy,The First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,Henan,China;Department of Cardiology,The First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,Henan,China)
关键词
慢性心衰
沙库巴曲缬沙坦钠
心功能
运动耐力
Chronic heart failure
Sacubitril valsartan sodium
Cardiac function
Exercise tolerance
