沙库巴曲缬沙坦及培哚普利治疗慢性心力衰竭的疗效对比
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摘要
目的探讨沙库巴曲缬沙坦及培哚普利对心力衰竭患者的疗效差异。方法将96例住院的心力衰竭患者分为对照组(常规药物+培哚普利)、观察组(常规药物+沙库巴曲缬沙坦)各48例,均治疗3周,观察治疗前后血清N端脑钠肽前体(NT-pro BNP)、血清肌钙蛋白T(cTnT)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、HR(心率)、血清尿素氮(BUN)、血肌酐(SCR)、肾小球滤过率(eGFR)、临床症状、心功能分级、不良反应、院内死亡及随访1个月内主要不良心血管事件的发生情况。结果与对照组相比,观察组NT-pro BNP、BUN、SCR明显降低,LVEF、eGFR明显升高,差异有统计学意义(P<0.05);cTnT、LVEDD、HR与对照组比较,差异无统计学意义(P>0.05);观察组临床症状较对照组减轻,心功能分级降低,治疗总有效率高于对照组,差异有统计学意义(P<0.05)。两组不良反应、院内死亡、随访1个月内MACE发生情况比较,差异无统计学意义(P>0.05)。结论与培哚普利相比,沙库巴曲缬沙坦能有效减轻心力衰竭患者的临床症状,改善心功能。
Objective To explore the difference of therapeutic effect between entresto and perindopril in the patients with chronic heart failure(CHF).Methods Ninety-six inpatients with CHF were divided into the control group(routine medication + perindopril)and observation group(routine medication + entresto),48 cases in each group.The medication treatment lasted for 3 weeks.The changes in serum NT-pro BNP,cTnT,LVEDD,LVEF,HR,serum BUN,blood SCR,eGFR,clinical symptoms,cardiac functional grading,adverse reactions,in-hospital mortality and occurrence situation of MACE within 1-month follow-up in the two groups were observed before and after treatment.Results Compared with the control group,the levels of NT-pro BNP,BUN and SCR in the observation group were significantly decreased,while LVEF and eGFR were significantly increased,and the differences were statistically significant(P<0.05);cTnT,LVEDD and HRhad no statistical difference the between two groups(P>0.05).The clinical symptoms in the observation group were alleviated and cardiac functional grade was decreased,the treatment total effective rate was higher than that in the control group,and the differences were statistically significant(P<0.05).The adverse reactions,in-hospital mortality and occurrenc situation of MACE within 1-month follow-up had no statistical differences between two groups(P>0.05).Conclusion Compared with perindopril,entresto can effectively relieve clinical symptoms and improve the cardiac function in the patients with CHF.
Objective To explore the difference of therapeutic effect between entresto and perindopril in the patients with chronic heart failure(CHF).Methods Ninety-six inpatients with CHF were divided into the control group(routine medication + perindopril)and observation group(routine medication + entresto),48 cases in each group.The medication treatment lasted for 3 weeks.The changes in serum NT-pro BNP,cTnT,LVEDD,LVEF,HR,serum BUN,blood SCR,eGFR,clinical symptoms,cardiac functional grading,adverse reactions,in-hospital mortality and occurrence situation of MACE within 1-month follow-up in the two groups were observed before and after treatment.Results Compared with the control group,the levels of NT-pro BNP,BUN and SCR in the observation group were significantly decreased,while LVEF and eGFR were significantly increased,and the differences were statistically significant(P<0.05);cTnT,LVEDD and HRhad no statistical difference the between two groups(P>0.05).The clinical symptoms in the observation group were alleviated and cardiac functional grade was decreased,the treatment total effective rate was higher than that in the control group,and the differences were statistically significant(P<0.05).The adverse reactions,in-hospital mortality and occurrenc situation of MACE within 1-month follow-up had no statistical differences between two groups(P>0.05).Conclusion Compared with perindopril,entresto can effectively relieve clinical symptoms and improve the cardiac function in the patients with CHF.
引文
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[11]PONIKOWSKI P,VOORS A A,ANKER S D,et al.2016ESC guidelines for the diagnosis and treatment of acute and chronic heart failure:the task force for the diagnosis and treatment of acute and chronic heart failure of the European society of cardiology(ESC).developed with the special contribution[J].Eur J Heart Fail,2016,18(8):891-975.
[12]WRITING C M,YANCY C W,JESSUP M,et al.2016ACC/AHA/HFSA focused update on new pharmacological therapy for heart failure:an update of the 2013 AC-CF/AHA guideline for the management of heart failure:a report of the American college of cardiology/American heart association task force on clinical practice guidelines and the heart failure society of America[J].Circulation,2016,134(13):e282-e293.
[13]MCMURRAY J J,PACKER M,DESAI A S,et al.Angiotensin-neprilysin inhibition versus enalapril in heart failure[J].N Engl J Med,2014,371(11):993-1004.
[2]MUROHARA T.Role of RAAS inhibitors for the treatment of heart failure[J].Nihon Rinsho,2012,70(9):1577-1581.
[3]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2014[J].中国实用乡村医生杂志,2014,21(24):3-10.
[4]邱爽,杨波,平海芹,等.血管紧张素受体脑啡肽酶抑制剂在心力衰竭中的研究进展[J].中国循环杂志,2015,30(11):1131-1133.
[5]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.慢性心力衰竭诊断治疗指南[J].中华心血管病杂志,2007,35(12):1076-1095.
[6]马宁,边瓯.芪苈强心胶囊对心力衰竭老年患者血清中乳糖凝集素-3和可溶性基质裂解素2含量的影响[J].中国老年学杂志,2015,35(13):3746-3748.
[7]DUNLAY S M,PEREIRA N L,KUSHWAHA S S.Contemporary strategies in the diagnosis and management of heart failure[J].Mayo Clinic Proceedings,2014,89(5):662-676.
[8]YANCY C W,JESSUP M,BOZKURT B,et al.2017ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure a report of the American college of cardiology/American heart association task force on clinical practice guidelines and the heart failure society of ameri[J].J Card Fail,2017,23(8):628-651.
[9]刘建国,田新利,李俊峡.心力衰竭的药物及非药物治疗[J].医学与哲学,2013,34(12):20-23.
[10]LIU Y X,STUDZINSKI C,BECKETT T,et al.Circulating neprilysin clears brain amyloid[J].Mol Cell Neurosci,2010,45(2):101-107.
[11]PONIKOWSKI P,VOORS A A,ANKER S D,et al.2016ESC guidelines for the diagnosis and treatment of acute and chronic heart failure:the task force for the diagnosis and treatment of acute and chronic heart failure of the European society of cardiology(ESC).developed with the special contribution[J].Eur J Heart Fail,2016,18(8):891-975.
[12]WRITING C M,YANCY C W,JESSUP M,et al.2016ACC/AHA/HFSA focused update on new pharmacological therapy for heart failure:an update of the 2013 AC-CF/AHA guideline for the management of heart failure:a report of the American college of cardiology/American heart association task force on clinical practice guidelines and the heart failure society of America[J].Circulation,2016,134(13):e282-e293.
[13]MCMURRAY J J,PACKER M,DESAI A S,et al.Angiotensin-neprilysin inhibition versus enalapril in heart failure[J].N Engl J Med,2014,371(11):993-1004.