2022 年第 1 期 第 17 卷

沙库巴曲缬沙坦对射血分数降低型慢性心力衰竭患者的临床疗效及对B型脑钠肽和C反应蛋白水平的影响

Clinical efficacy of sacubitril valsartan on patients with chronic heart failure with reduced ejection fraction and its influence on brain natriuretic peptide and C-reactive protein levels 

作者：刘海燕宋毓青陈永福付丽徐文晶高巍

英文作者：Liu Haiyan Song Yuqing Chen Yongfu Fu Li Xu Wenjing Gao Wei

单位：首都医科大学附属北京地坛医院心内科，北京100015

英文单位：Department of Cardiology Beijing Ditan Hospital Capital Medical University Beijing 100015 China

关键词：慢性心力衰竭；沙库巴曲缬沙坦；心功能；B型脑钠肽；C反应蛋白；心室重构

英文关键词：Chronicheartfailure;Sacubitrilvalsartan;Cardiacfunction;Brainnatriureticpeptide；C-reactiveprotein；Ventricularremodeling

• 摘要：

• 目的  探讨沙库巴曲缬沙坦对射血分数降低型慢性心力衰竭患者的临床疗效及对B型脑钠肽（BNP）、C反应蛋白（CRP）水平的影响。方法 选取2018年10月至2020年10月在首都医科大学附属北京地坛医院心内科住院的射血分数降低型慢性心力衰竭患者80例，采取随机数字表法分为对照组和观察组，各40例。对照组采用常规基础治疗联合培哚普利治疗；观察组在常规治疗基础上加用沙库巴曲缬沙坦治疗。比较2组患者治疗3个月后的临床效果、心功能指标［左心室收缩末期内径（LVESD）、左心室舒张末期内径（LVEDD）、左心室射血分数（LVEF）］、B型脑钠肽（BNP）及C反应蛋白（CRP）水平，观察不良反应发生情况。结果 观察组临床总有效率明显高于对照组［95.0%（38/40）比65.0%（26/40）］，差异有统计学意义（P＜0.001）。治疗后，2组LVESD、LVEDD均明显小于治疗前，LVEF明显高于治疗前，且观察组LVESD、LVEDD明显小于对照组，LVEF明显高于对照组，差异均有统计学意义（均P＜0.05）。治疗后，2组BNP水平及观察组CRP水平低于治疗前，且观察组BNP、CRP水平均低于对照组，差异均有统计学意义（均P＜0.05）。观察组不良反应发生率明显低于对照组［10.0%(4/40)比30.0%(12/40)］，差异有统计学意义（P=0.016）。结论  沙库巴曲缬沙坦治疗射血分数降低型慢性心力衰竭患者疗效较好，可改善心功能，显著降低BNP和CRP水平，且安全性较好。

• Objective   To investigate the clinical efficacy of sacubitril valsartan on patients with chronic heart failure with reduced ejection fraction and its influence on brain natriuretic peptide (BNP) and C-reactive protein (CRP) levels. Methods  Totally 80 patients with chronic heart failure with reduced ejection fraction hospitalized in Department of Cardiology, Beijing Ditan Hospital, Capital Medical University from October 2018 to October 2020 were enrolled. They were randomly divided into control group and observation group, with 40 cases in each group. The control group was treated with routine treatment combined with perindopril and the observation group was treated with sacubitril valsartan on the basis of routine treatment. The clinical effects, cardiac function indexes ［left ventricular end systolic diameter (LVESD), left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF)］, BNP and CRP levels were compared between the two groups 3 months after treatment. The occurrence of adverse reactions was observed. Results  The total clinical effective rate in the observation group was significantly higher than that in the control group［95.0%（38/40） vs 65.0%（26/40）］（P＜0.001）. After treatment, LVESD and LVEDD significantly decreased and LVEF significantly increased in the two groups; LVESD and LVEDD in the observation group were significantly lower than those in the control group, and LVEF in the observation group was significantly higher than that in the control group (all P＜0.05). After treatment, the levels of BNP in the two groups and CRP in the observation group were lower than those before treatment, and the levels of BNP and CRP in the observation group were lower than those in the control group (all P＜0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group［10.0%(4/40) vs 30.0%(12/40)］(P=0.016). Conclusions  Sacubitril valsartan has good curative effect on patients with chronic heart failure with reduced ejection fraction. It can improve cardiac function and significantly reduce the levels of BNP and CRP, which has good safety.