芪参益气滴丸联合沙库巴曲缬沙坦治疗高龄射血分数保留心力衰竭的疗效观察

摘要/Abstract

摘要： 目的探讨芪参益气滴丸联合低剂量沙库巴曲缬沙坦对高龄射血分数保留心力衰竭患者心功能及血清hs-CRP、IL-6水平的影响。方法将66例高龄射血分数保留心力衰竭患者随机分为观察组（n=33）与对照组（n=33）,对照组给予常规抗心衰治疗基础上并给予低剂量沙库巴曲缬沙坦钠治疗,观察组患者应用芪参益气滴丸联合低剂量沙库巴曲缬沙坦治疗,比较两组患者临床疗效及治疗前后心功能指标（超声心动图、血清NT-proBNP）及hs-CRP、IL-6水平的变化,比较两组不良事件发生率。结果观察组总有效率为90.90%,较对照组（69.09%)明显升高（P<0.05）;观察组治疗后血清NT-proBNP、hs-CRP、IL-6水平较治疗前明显下降,且显著低于对照组,差异均有统计学意义（P<0.05）。两组不良反应发生率分别为18.18%（6/33）与15.15%（5/33）,差异无统计学意义（P>0.05）。结论芪参益气滴丸联合低剂量沙库巴曲缬沙坦治疗高龄射血分数保留心力衰竭患者,可以明显改善患者的心功能、抑制炎症反应、可显著提高临床疗效。

关键词: 射血分数保留心力衰竭, 沙库巴曲缬沙坦钠, 芪参益气滴丸, 高龄, IL-6

陈日锦, 江玲, 王晓玉. 芪参益气滴丸联合沙库巴曲缬沙坦治疗高龄射血分数保留心力衰竭的疗效观察[J]. 心血管病防治知识, 2021, 11(10): 25-28.

参考文献

[1] 张妮,王华,方芳,等. 结合尸检报告分析80岁以上老年人患病疾病谱及死亡原因[J]. 中华老年医学杂志,2018,37(5):565-569.
[2] 糜涛,张存泰. 老年人慢性心力衰竭[J]. 中华老年医学杂志,2016,35(3):236-238.
[3] Farris S D, Moussavi-Harami F, Stempien-Otero A.Heart failure with preserved ejection fraction and skeletal muscle physiology[J]. Heart Failure Reviews,2017,22(2):141-148.
[4] 柴坷,王华,杨杰孚. 射血分数保留性心力衰竭的病理生理机制和治疗进展[J]. 中国循环杂志,2016,31(9):921-923.
[5] 叶文锋,黄杰雄. 沙库巴曲缬沙坦钠联合芪参益气滴丸治疗慢性心衰的疗效及安全性观察[J]. 中国实用医药,2020,15(18):108-110.
[6] 中华医学会心血管病学分会心力衰竭学组,中国医师协会心力衰竭专业委员会,中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南2018[J]. 中华心血管病杂志,2018,46(10):760-789.
[7] 中华医学会心血管病学分会,中国心肌炎心肌病协作组. 中国扩张型心肌病诊断和治疗指南[J]. 临床心血管病杂志,2018,34(5):421-434.
[8] O Meara E, Mcdonald M, Chan M, et al. CCS/CHFS Heart Failure Guidelines: Clinical Trial Update on Functional Mitral Regurgitation, SGLT2 Inhibitors, ARNI in HFpEF, and Tafamidis in Amyloidosis[J]. Canadian Journal of Cardiology,2020,36(2):159-169.
[9] Kuster G M, Pfister O.Chronic heart failure: advances in pharmacological treatment and future perspectives[J]. Swiss medical weekly,2019,149:20036.
[10] 董志华,唐敏. 沙库巴曲缬沙坦钠治疗射血分数保留心力衰竭的临床效果[J]. 中国当代医药,2020,27(16):51-54.
[11] Yasunori S, Yasunori S, Jing W, et al.LCZ696 (Sacubitril/valsartan), an Angiotensin-Receptor Neprilysin Inhibitor, Attenuates Cardiac Hypertrophy, Fibrosis and Vasculopathy in a Rat Model of Chronic Kidney Disease[J]. Journal of Cardiac Failure,2018.
[12] Fu S, Ping P, Wang F, et al.Synthesis, secretion, function, metabolism and application of natriuretic peptides in heart failure[J]. Journal of Biological Engineering,2018,12(1).
[13] Díez J.Chronic heart failure as a state of reduced effectiveness of the natriuretic peptide system: implications for therapy[J]. European Journal of Heart Failure,2017,19(2):167-176.
[14] Mcmurray J J V, Packer M, Desai A S, et al. Angiotensin-Neprilysin Inhibition versus Enalapril in Heart Failure[J]. The New England journal of medicine,2014,371(11):993-1004.
[15] Nicholas Y.Tan Md M A, B L R S M, S. Jeson Sangaralingham Ms P A, et al. Comparative Effectiveness of Sacubitril-ValsartanVersus ACE/ARB Therapy in Heart Failure With ReducedEjection Fraction[J]. JACC: Heart Failure,2020,8(1):43-54.
[16] Martens P, Verluyten L, Van de Broek H, et al. Determinants of maximal dose titration of sacubitril/valsartan in clinical practice[J]. Acta Cardiologica,2019:1-10.
[17] Cosentino E R, Degli Esposti D, Miceli R, et al.Sacubitril/valsartan improves both functional and echocardiographic parameters in patients with chronic heart failure with reduced ejection fraction[J]. Current Medical Research and Opinion,2019,35(1):9-12.
[18] 朱林,洪梅. 沙库巴曲/缬沙坦在心血管疾病治疗中的研究进展[J]. 中华老年多器官疾病杂志,2020,19(5):384-387.
[19] Mckie P M, Burnett J C.NT-proBNP: The Gold Standard Biomarker in Heart Failure[J]. Journal of the American College of Cardiology,2016,68(22):2437-2439.
[20] Cunningham J W, Vaduganathan M, Claggett B L, et al.Effects of Sacubitril/Valsartan on N-Terminal Pro-B-Type Natriuretic Peptide in Heart Failure With Preserved Ejection Fraction[J]. JACC: Heart Failure,2020,8(5):372-381.
[21] Wettersten N, Maisel A S.Biomarker developments in heart failure[J]. Current Opinion in Cardiology,2019,34(2):218-224.
[22] 王晶莹,刘洋. 血清胱抑素C、白细胞介素-6及超敏C反应蛋白与慢性心力衰竭的相关性研究[J]. 国际检验医学杂志,2018,39(12):1530-1532, 1536.
[23] 张杰,赖润民,鞠建庆,等. 芪参益气滴丸治疗射血分数保留心力衰竭的网络药理学研究[J]. 中国医药导报,2020,17(1):21-24.
[24] 王伊丽,李澜,徐赟晟,等. 芪参益气滴丸在心血管系统疾病模型中的药理作用研究进展[J]. 天津中医药大学学报,2018,37(2):169-172.
[25] 曹士强. 曲美他嗪联合芪参益气滴丸治疗左室射血分数保留型心力衰竭的效果研究[J]. 当代医药论丛,2017,15(1):138-139.