沙库巴曲缬沙坦治疗顽固性心力衰竭的疗效与安全性观察
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摘要
目的探讨沙库巴曲缬沙坦治疗顽固性心力衰竭中的疗效及安全性。方法选择心内科住院的顽固性心力衰竭患者80例,分为观察组48例及对照组32例,两组于常规治疗基础上,观察组给予沙库巴曲缬沙坦50mg口服2次/d治疗,对照组给予米力农注射液微泵注射维持72h,所有患者出院后随访3个月,记录治疗前后血压、脑钠钛(BNP)、血肌酐、电解质、心脏超声数据,评估沙库巴曲缬沙坦的疗效及安全性。结果沙库巴曲缬沙坦可显著改善顽固性心力衰竭患者生活质量(总有效率97.9%),改善顽固心力衰竭患者左心室舒张末期内径水平[(5.78±0.54)cm vs.(5.46±0.52)cm,P<0.01]、提高左心室射血分数[(30.85±5.06)%vs.(40.21±6.16)%,P<0.01]及短轴缩短率水平[(23.00±5.15)%vs.(31.47±4.94)%,P<0.05],对电解质、血肌酐水平均无明显影响。结论沙库巴曲缬沙坦治疗顽固性心力衰竭有良好的治疗效果及较高的安全性。
Objective To evaluate the efficacy and safety of Entresto in treatment of patients with refractory heart failure. Methods 80 inpatients with refractory heart failure were divided into observation group and control group. The observation group was treated with Entresto 50 mg twice daily and the control group was treated with milrinone injection for 72 h based on conventional therapy. All cases were followed up for 3 months after discharge. Blood pressure, BNP, serum creatinine, electrolytes and echocardiographic data were recorded before and after treatment to evaluate the efficacy and safety of Entresto. Results Entresto significantly improved life quality of patients with refractory heart failure(the total effective rate is 97.9%), left ventricular end-diastolic diameter(5.78 ±0.54)cm vs.(5.46 ±0.52)cm, P <0.05, left ventricular ejection fraction(30.85 ±5.06)% vs.(40.21 ±6.16)%, P <0.05) and fraction shortening rate((23.00 ±5.15)% vs.(31.47 ±4.94)%, P <0.05)in patients with refractory heart failure. There was no adverse effect on serum electrolyte and creatinine.Conclusion Entresto is efficacy and safety in the treatment of refractory heart failure patients.
Objective To evaluate the efficacy and safety of Entresto in treatment of patients with refractory heart failure. Methods 80 inpatients with refractory heart failure were divided into observation group and control group. The observation group was treated with Entresto 50 mg twice daily and the control group was treated with milrinone injection for 72 h based on conventional therapy. All cases were followed up for 3 months after discharge. Blood pressure, BNP, serum creatinine, electrolytes and echocardiographic data were recorded before and after treatment to evaluate the efficacy and safety of Entresto. Results Entresto significantly improved life quality of patients with refractory heart failure(the total effective rate is 97.9%), left ventricular end-diastolic diameter(5.78 ±0.54)cm vs.(5.46 ±0.52)cm, P <0.05, left ventricular ejection fraction(30.85 ±5.06)% vs.(40.21 ±6.16)%, P <0.05) and fraction shortening rate((23.00 ±5.15)% vs.(31.47 ±4.94)%, P <0.05)in patients with refractory heart failure. There was no adverse effect on serum electrolyte and creatinine.Conclusion Entresto is efficacy and safety in the treatment of refractory heart failure patients.
引文
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[10]Seferovic JP,Claggett B.Effect of sacubitril/valsatan versus enalapril on glycaemic control in patients with heart failure and diabetes∶a post-hoc analysis from the PARADIGM-HF trial[J].Lancet Dabetes Endorinol,2017,5(5)∶333-340.DOI∶10.1016/S2213-8587(17)30087-6.
[2]王休荣.米力农治疗难治性心力衰竭93例[J].中国实用医刊,2012,39(4)∶62-63.DOI∶10.3760/cma.j.issn.1674-4756.2012.04.030.
[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].中华心血管病杂志,2014,42(2)∶98-122.DOI∶10.3969/j.issn.1672-7185.2015.04.002.
[4]俞海峰,周德震,程震锋,等.小剂量重组人利尿他治疗机械失代偿性心力衰竭的疗效研究[J].心电与循环,2013,32(5)∶385-386.DOI∶10.3969/j.issn.10 02-1094.201 3.05.011.
[5]Mc Murray JJ.Clinical practice.Systolic heart failure[J].N Engl JMed,2010,362∶228-238.DOI∶10.1056/NEJMcp0909392.
[6]Shah AM,Mann DL.In search of new therapeutic targets and strategies for heart failure:recent advances in basic science[J].Lancet,2011,378∶704-712.DOI∶10.1016/S0140-6736(11)60894-5.
[7]Thackmy S,Easthaugh J,Freemantle N,et al.The effectiveness andrelative effectiveness of intravenous inotroPic drugs acting through the adrenergic pathway in patients with heart failure-a metaregressionanalysis[J].Eur J Heart Fail,2002(4)∶515-529.DOI∶10.1016/s1388-9842(02)00041-7.
[8]Sacubitr l/Vasartan(Entresto)for Heart Failure.JAMA.2015,314(7)∶722-723.DOI∶10.1001/jama.2015.9398.
[9]Braunwald E.The path to an angiontensin receptor antagonistneprilysin inhiibitor in the treatment of heart failure[J].J Amcoll Cardiol,2015,65(10)∶1029-1041.DOI∶10.1016/j.jacc.2015.01.033.
[10]Seferovic JP,Claggett B.Effect of sacubitril/valsatan versus enalapril on glycaemic control in patients with heart failure and diabetes∶a post-hoc analysis from the PARADIGM-HF trial[J].Lancet Dabetes Endorinol,2017,5(5)∶333-340.DOI∶10.1016/S2213-8587(17)30087-6.