沙库巴曲缬沙坦和盐酸贝那普利对急性失代偿性心力衰竭患者血清NT-proBNP cTnT水平和心脏超声功能指标的影响

doi:10.3969/j.issn.1006-6233.2023.05.032

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Abstract Objective: To analyze the intervention effects of sacubitril/valsartan and benazepril Hydrochloride on patients with acute decompensated heart failure (ADHF). Methods: A total of 126 patients with ADHF who were treated in Department of Emergency Medicine and Department of Cardiovascular Medicine of our hospital between December 2019 and February 2022 were selected and divided into observation group (conventional western medicine+sacubitril/valsartan, n=63) and control group (conventional western medicine+benazepril, n=63) by the non-randomized concurrent control trial and voluntary principle of patients. Both groups were treated for 8 weeks. The cardiac function grading, 6-minute walk test (6MWT), cardiac function ultrasound indicators and serological indicators before and after treatment and adverse drug reactions during treatment were compared between the two groups. The prognosis within 3 months after discharge was recorded in the two groups. Results: During treatment, 1 case was excluded from control group and the remaining 62 effective cases were obtained. The NYHA cardiac function grading and 6MWT distance in the two groups after treatment were significantly improved compared with those before treatment (P<0.05), and the improvement of 6MWT distance before and after treatment in observation group was significantly higher than that in control group [116.17±12.25) VS (99.95±10.64)] (P<0.05). After treatment, the increase of LVEF in observation group was significantly higher than that in control group [(7.73±1.03) VS (4.95±0.89)] while the decreases of LVIDd, LVIDs and LA were significantly lower than those in control group [(-7.74±1.05) VS (-3.60±0.42), (-8.91±1.89) VS (-6.74±1.15), (-4.62±0.51) VS (-1.81±0.20)] (P<0.05). The reductions of serum NT-proBNP, cTnT and CK-MB levels in observation group after treatment were significantly higher compared with those in control group [(1243.25±100.64) VS (1060.88±110.35), (0.07±0.02) VS (0.06±0.01), (14.57±3.27) VS (11.15±4.60)] (P<0.05). The incidence rate of adverse reactions during treatment in observation group was 6.35% (4/63) and was 4.84% (3/62) in control group (P>0.05). During follow-up, there were 6 cases of readmission and 2 cases of all-cause death in observation group, and 10 cases of readmission and 3 cases of all-cause death in control group, and there was no significant difference in the incidence rate of poor prognosis between the two groups (P>0.05). Conclusion: Compared with benazepril hydrochloride, sacubitril/valsartan in the treatment of ADHF can more significantly improve the cardiac function and reduce the levels of serum markers with a better efficacy.

Key words： Acute decompensated heart failure Sacubitril/valsartan Benazepril hydrochloride Cardiac function

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2023.05.032 OR http://www.hbyxzzs.cn/EN/Y2023/V29/I5/861

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