| 郝启萌,程 锦,薛玉刚,纪兆乐,张 薇,汪 洁.比较沙库巴曲缬沙坦与缬沙坦对慢性心衰患者心肾功能的影响[J].,2019,19(14):2691-2694 |
| 比较沙库巴曲缬沙坦与缬沙坦对慢性心衰患者心肾功能的影响 |
| Comparison of the Effects of Sacubitril/valsartan and Valsartan on Heart and Kidney Function in Patients with Chronic Heart Failure |
| 投稿时间：2018-12-18 修订日期：2019-01-13 |
| DOI：10.13241/j.cnki.pmb.2019.14.018 |
| 中文关键词: 慢性心力衰竭 沙库巴曲缬沙坦 缬沙坦 血肌酐 胱抑素C |
| 英文关键词: Chronic heart failure Sacubitril/valsartan Valsartan Scr CysC |
| 基金项目:国家自然科学基金项目（81470537） |
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| 中文摘要: |
| 摘要 目的：比较沙库巴曲缬沙坦与缬沙坦在慢性心力衰竭（Chronic heart failure, CHF）患者治疗中对心功能及肾功能的影响。方法：按WHO诊断标准随机选择CHF患者，对照组30例，给予缬沙坦80 mg/qd起，2-4周后增至160 mg/qd；研究组30例，给予沙库巴曲缬沙坦100 mg/bid，2-4周后增至200 mg/bid。治疗8周后，比较两组治疗后LVEF、LVESD和LVEDD的变化，以及对Scr、CysC的影响。结果：（1）两组患者的性别、年龄、NYHA心功能分级等一般情况，以及治疗前LVEF、LVESD、LVEDD、Scr、CysC等指标比较均无显著性差异（P>0.05），具有可比性。（2）治疗8周后，对照组的LVEF较治疗前显著升高（38.87±6.95 %VS.34.73±7.89 %，P<0.05），LVESD、LVEDD均较治疗前显著降低（44.43±8.26 mmVS.50.77±8.31 mm，P<0.05；54.77±5.84 mmVS.59.87±7.57 mm，P<0.05），CysC较治疗前显著降低（1.00±0.33 mg/LVS.1.27±0.52 mg/L，P<0.05），Scr较治疗前无显著性差异（82.24±30.38 ?滋mol/LVS.91.19±36.81 μmol/L，P>0.05）。研究组的LVEF较治疗前显著升高（38.70±7.29%VS.33.53±9.12%，P<0.05），LVESD、LVEDD均较治疗前显著降低（43.33±9.10 mmVS.49.47±6.84 mm，P<0.05；54.53±6.20 mmVS.60.23±8.30 mm，P<0.05），CysC较治疗前显著降低（1.01±0.26 mg/LVS.1.32±0.53 mg/L，P<0.05），Scr较治疗前无显著性差异（84.31±32.25 μmol/LVS.94.43±38.73 μmol/L，P>0.05）。比较两组治疗后各项指标均无显著性差异（P>0.05）。结论：在CHF的治疗过程中，沙库巴曲缬沙坦与缬沙坦均能改善心功能，且在短时间内具有一定的肾功能保护作用。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the effects of sacubitril/valsartan and valsartan on cardiac function and renal function in patients with chronic heart failure. Methods: CHF patients were randomly selected according to WHO diagnostic criteria. 30 cases as control group were given valsartan 80 mg/qd, increased to 160 mg/qd after 2-4 weeks, and 30 cases as study group were given sacubitril/valsartan 100 mg/bid, increased to 200 mg/bid after 2-4 weeks. After 8 weeks of treatment, compared the changes of LVEF, LVESD and LVEDD and the effects on Scr and CysC between the two groups. Results: (1)Comparing the general conditions of gender, age and NYHA heart function classification of the two groups, as well as the pre-treatment in LVEF, LVESD, LVEDD, Scr and CysC, there were no significant difference(P>0.05), comparable. (2)After 8 weeks of treatment, LVEF in the control group was significantly higher than pre-treatment(38.87±6.95 % vs. 34.73±7.89 %, P<0.05), while the level of LVESD, LVEDD were significantly lower than pre-treatment(44.43±8.26 mm vs. 50.77±8.31 mm, P<0.05; 54.77±5.84 mm vs. 59.87±7.57 mm, P<0.05), and the level of CysC is the same(1.00±0.33 mg/L vs.1.27±0.52 mg/L, P<0.05). But there was no significant difference in the level of Scr compared with pre-treatment(82.24±30.38 μmol/L vs. 91.19±36.81 μmol/L, P>0.05). In the study group, the level of LVEF was significantly higher than pre-treatment(38.70±7.29 % vs.33.53±9.12 %, P<0.05), and the level of LVESD, LVEDD of control group were significantly lower than pre-treatment(43.33±9.10 mm vs. 49.47±6.84 mm, P<0.05; 54.53±6.20 mm vs. 60.23±8.30 mm, P<0.05), as well as the level of CysC(1.01±0.26 mg/L vs. 1.32±0.53 mg/L, P<0.05). As with the control group, there was no significant difference in Scr levels(84.31±32.25 μmol/L vs. 94.43±38.73 μmol/L, P>0.05). At the same time, there was no significant difference between the two groups after treatment(P>0.05). Conclusion: In the treatment of chronic heart failure, both sacubitril/valsartan and valsartan can improve cardiac function and have a certain renal function protection in a short time. |
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