目的 探讨沙库巴曲缬沙坦钠片对慢性心力衰竭患者的疗效及对神经内分泌激素活性的影响.方法 选取2017年11月至2018年10月在北京市第六医院就诊的慢性心力衰竭患者60例,按照随机数字表法分为观察组和对照组,各30例.对照组在一般治疗基础上加用缬沙坦胶囊治疗; 观察组在一般治疗基础上加用沙库巴曲缬沙坦钠片治疗.比较2组临床疗效和治疗前及治疗12周后神经内分泌激素水平,包括血浆去甲肾上腺素、醛固酮和血管紧张素Ⅱ(Ang Ⅱ) .结果 治疗后,观察组总有效率明显高于对照组[83.3％(25 /30) 比53.3％(16 /30) ],差异有统计学意义(χ2 = 6.239,P = 0.012) .治疗前,2组患者血浆去甲肾上腺素、醛固酮、Ang Ⅱ水平比较,差异均无统计学意义(均P > 0.05) .治疗后,观察组血浆去甲肾上腺素、醛固酮、Ang Ⅱ水平均明显低于治疗前和对照组[(1 658 ± 243) pmol /L比(2 387 ± 368) 、 (2 060 ±289) pmol /L; (247 ±14) ng/L比(309 ±27) 、(283 ±19) ng/L; (99 ±8) ng/L比(118 ±9) 、(114 ±9) ng/L],差异均有统计学意义(均P < 0.05) .结论 沙库巴曲缬沙坦钠片用于慢性心力衰竭的治疗能够有效改善症状,并抑制神经内分泌激素的过度激活.%Objective To investigate the therapeutic effect of sacubitril /valsartan sodium tablets on patients with chronic heart failure and the effect on neuroendocrine hormone activity. Methods A total of 60 patients with chronic heart failure admitted to Beijing No. 6 Hospital from November 2017 to October 2018 were randomly divided into observation group and control group,with 30 cases in each group. On the basis of routine treatment,the control group took valsartan capsules and the observation group took sacubitril /valsartan sodium tablets. Clinical efficacy and levels of plasma neuroendocrine hormones including norepinephrine,aldosterone and angiotensin Ⅱ(Ang Ⅱ) before and 12 weeks treatment were analyzed. Results Total effective rate in observation group was significantly higher than that in control group[83.3％ (25 /30) vs 53.3％ (16 /30) ](χ2 = 6.239,P =0.012). Before treatment,there was no significant difference of noradrenaline,aldosterone and Ang Ⅱ between groups(all P > 0.05). After treatment,levels of noradrenaline,aldosterone and Ang Ⅱ in observation group were significantly lower than those in control group[(1 658 ± 243) pmol /L vs (2 387 ± 368) ,(2 060 ± 289) pmol /L; (247 ± 14) ng /L vs (309 ± 27) ,(283 ± 19) ng /L; (99 ± 8) ng /L vs (118 ± 9) ,(114 ± 9) ng /L](all P < 0.05). Conclusion Sacubitril /valsartan salium tablets can effectively improve clinical symptoms and inhibit the over-activation of neuroendocrine hormones in the treatment of chronic heart failure.
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