沙库巴曲缬沙坦钠治疗慢性心力衰竭患者的临床疗效分析

目的:探究沙库巴曲缬沙坦钠与盐酸贝那普利治疗射血分数降低的慢性心力衰竭（HFrEF）患者12周后的临床疗效。方法:选取2017年11月至2018年9月在南昌大学第三附属医院诊治的射血分数降低的慢性心衰患者52例，随机分成对照组（25例）及治疗组（27例）。两组分别给与常规抗心衰治疗，对照组给与盐酸贝那普利10 mg每日一次口服治疗，每两周调整一次剂量（根据患者对药物的耐受情况），直至目标剂量20 mg每日一次。治疗组在停血管紧张素转换酶抑制剂（ACEI） 36 h后转化为沙库巴曲缬沙坦钠50 mg每日两次口服治疗，每两周调整一次剂量（根据患者对药物的耐受情况），直至达目标剂量200 mg每日两次。两组患者均持续治疗12周。观察两组患者用药后临床疗效，同时比较治疗前后两组患者氨基末端脑钠尿肽(NT-proBNP)、6 min步行距离、左室射血分数（LVEF）、左室舒张末径（LVEDD）和明尼苏达生活量表（MLHFQ）评分。结果:治疗后，对照组临床治疗有效率达72.00%，但明显低于治疗组的92.60%，两组比较差异有统计学意义（P＜0.05）。治疗后，两组患者 6 min步行距离、NT-proBNP、LVEF、LVEDD和明尼苏达生活量表（MLHFQ）评分均较治疗前改善，差异有统计学意义（P＜0.05），且治疗组改善更明显（P＜0.05）。结论:沙库巴曲缬沙坦钠治疗慢性心衰临床疗效好，安全性高，可以进一步临床推广应用。

Clinical efficacy of sacubitril valsartan in the treatment of chronic heart failure

AIM: To investigate the clinical effects of sacubitril valsartan and benazepril hydrochloride on heart function in patients with heart failure reduced ejection fraction（HFrEF）after two months of treatment. METHODS: Patients (52 cases) with heart failure reduced ejection fraction hospitalized in Third Affiliated Hospital of Nanchang University from November 2017 to September 2018 were divided into control (25 cases) and treatment (27cases) groups according to different treatments. Two groups of patients were given conventional anti-heart failure treatment. The control group was treated with benazepril hydrochloride 10 mg orally once a day and the dose was doubled every 2 weeks until the target dose was 20 mg orally 1time per day. The treatment group was treated with sacubitril valsartan 50 mg orally twice daily after stop ACEI 36 hours, and the dose was doubled every 2 weeks until the target dose was 200 mg orally 2 times per day. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and 6 min walking distance, the NT-pro BNP levels, LVEF,LVEDD,MLHFQ scores in two groups before and after treatment were compared.RESULTS:After treatment, the clinical efficacy in the control group was 72.00%, which was significantly lower than 92.60% in the treatment group (P＜0.05). After treatment, the 6 min walking distance in two groups were significantly increased.The NT-pro BNP levels, LVEF,LVEDD,and MLHFQ scores were decreased, and the difference was statistically significant in the same group (P＜0.05). The treatment group was significantly improved compared with control group (P＜0.05). CONCLUSION:Sacubitril valsartan has significant curative effect and high safety in the treatment of chronic heart failure.