萨库比特利缬沙坦钠与依那普利对非瓣膜射血分数降低型心衰患者临床疗效的比较分析

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research Pub Date : 2024-10-01
Qinqqing Zhang, Jiao Wang, Yingxiao Da, Xin Li, Lei Pan
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引用次数: 0

摘要

目的:心力衰竭是一种常见的心血管疾病,发病率逐年上升。对于合并非瓣膜性射血分数降低的心力衰竭患者,药物治疗一直是治疗的关键。本研究旨在探讨萨库比特利缬沙坦钠和依那普利对此类患者的临床疗效:研究设计:本研究采用前瞻性观察设计。从 2020 年 2 月至 2022 年 2 月,我们纳入了 123 例在邢台市第三医院接受治疗的非瓣膜性心力衰竭且射血分数降低的患者。根据治疗方案,患者被分为两组:A组(61人)接受依那普利治疗,B组(62人)接受硝苯地平治疗。所有患者均接受常规治疗。我们比较了两组患者治疗 8 周后的疗效。研究期间,我们记录了两组患者治疗前后的实验室指标、超声心动图指标、心血管指标以及可能出现的不良反应:治疗 8 周后,B 组的有效率高于 A 组(P < .05)。两组患者治疗前后的总蛋白、总胆红素、总胆固醇和血清肌酐水平无差异(P > .05)。两组治疗后的血清肌酐水平均高于治疗前,B 组低于 A 组(P < .05)。两组治疗前后的总蛋白、总胆红素和总胆固醇水平差异无统计学意义(P > .05),两组治疗前的血清肌酐水平差异无统计学意义(P > .05),治疗后的血清肌酐水平高于治疗前,B 组低于 A 组(P < .05)。治疗前,两组间高敏肌钙蛋白 T 和 n 端脑钠肽以及环磷酸鸟苷的水平无明显差异(P > .05)。治疗后,两组的高敏肌钙蛋白 T 和 N 端脑钠肽水平均低于治疗前,B 组低于 A 组;A 组的环磷酸鸟苷水平低于治疗前,B 组的环磷酸鸟苷水平高于治疗前,B 组高于 A 组(P < .05)。本研究中,B 组治疗有效率明显高于 A 组,说明 B 组治疗效果更好。此外,两组患者在一系列生化指标上无明显差异,但值得注意的是,治疗后,B 组患者的血清肌酐水平明显低于 A 组,这可能说明 B 组患者的治疗不仅更有效,还能降低某些不良心血管事件的发生风险:研究的主要结果表明,对于心力衰竭和非瓣膜性射血分数降低的患者,沙库比特利缬沙坦钠的临床疗效优于依那普利。具体而言,该药能明显改善患者的肾功能,降低心血管标志物水平,减少心血管不良事件的发生率。这些发现对指导心衰患者的治疗选择具有重要的临床意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Comparative Analysis of the Clinical Efficacy of Sacubitril Valsartan Sodium and Enalapril in Patients with Non-Valvular Ejection Fraction Reduction in Heart Failure.

Objective: Heart failure is a common cardiovascular disease, and its prevalence is increasing year by year. For patients with heart failure combined with non-valvular reduced ejection fraction, drug therapy has always been a key treatment. This study aimed to explore the clinical efficacy of sacubitril valsartan sodium and enalapril in such patients.

Methods: Study design: This study used a prospective observational design. From February 2020 to February 2022, we included 123 patients with non-valvular heart failure and reduced ejection fraction who were treated in Xingtai Third Hospital. Patients were divided into two groups according to the treatment plan: Group A (n=61) received enalapril, and Group B (n=62) received nifedipine. All patients received conventional treatment. We compared the efficacy of the two groups of patients 8 weeks after treatment. During the study, the laboratory indicators, echocardiographic indicators, cardiovascular markers, and possible adverse reactions of the two groups of patients before and after treatment were recorded.

Results: After 8 weeks of treatment, the effective rate of group B was higher than group A (P < .05). There were no differences in the levels of total protein, total bilirubin, total cholesterol and serum creatinine between the two groups before and after treatment (P > .05). The serum creatinine level in the two groups after treatment was higher than that before treatment, and the level in group B was lower than that in group A (P < .05). There were no statistically significant differences in the levels of total protein, total bilirubin and total cholesterol between the two groups before and after treatment (P > .05), and there was no statistically significant difference in the level of serum creatinine between the two groups before treatment (P > .05), and the level of serum creatinine after treatment was higher than that before treatment, and the level of group B was lower than that of group A (P < .05). Before treatment, there was no significant difference in the levels of high-sensitive troponin T and n-terminal brain natriuretic peptide and cyclic guanosine phosphate between the two groups (P > .05). After treatment, the levels of high-sensitive troponin T and N-terminal brain natriuretic peptide in the two groups were lower than those before treatment, and those in group B were lower than those in group A. The level of cyclic guanosine phosphate in group A was lower than that before treatment, the level of cyclic guanosine phosphate in group B was higher than that before treatment, and the level of group B was higher than that of group A (P < .05). The incidence of adverse cardiovascular events in group B was lower than that in group A (P < .05).In this study, the effective rate of treatment group B was significantly higher than that of treatment group A, indicating that treatment group B had a better therapeutic effect. In addition, there were no significant differences between the two groups in a series of biochemical parameters, but it is worth noting that after treatment, the serum creatinine level of group B was significantly lower than that of group A, which may indicate that the treatment of group B is not only more effective but also Reduces the risk of certain adverse cardiovascular events.

Conclusion: The main findings of the study showed that Sacubitril valsartan sodium showed better clinical efficacy than enalapril in patients with heart failure and non-valvular reduced ejection fraction. Specifically, the drug significantly improved patients' kidney function, reduced cardiovascular marker levels, and reduced the incidence of adverse cardiovascular events. These findings have important clinical implications for guiding treatment selection in patients with heart failure.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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