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沙库巴曲缬沙坦治疗糖尿病合并急性心肌梗死后射血分数中间值的心衰的疗效及安全性。

Efficacy and safety of sacubitril valsartan in treating heart failure with midrange ejection fraction after acute myocardial infarction in diabetic patients.

机构信息

Department of Cardiology, Wenzhou People's Hospital, The Third Affiliated Hospital of Shanghai University, Wenzhou, Zhejiang, China.

Wenzhou Medical University, Wenzhou, Zhejiang, China.

出版信息

Medicine (Baltimore). 2022 Feb 4;101(5):e28729. doi: 10.1097/MD.0000000000028729.

Abstract

Objective to evaluate the clinical efficacy and safety of sacubitril valsartan in the treatment of heart failure (HF) with midrange ejection fraction after acute myocardial infarction (AMI) in diabetic patients. From January 2015 to July 2020, HF patients with diabetes mellitus complicated with AMI were retrospectively analyzed. According to the medication, they were divided into 2 groups, that is, sacubitril valsartan group (84 cases) and valsartan group (86 cases). Valsartan group took valsartan capsule (80 mg/capsule, Beijing Novartis Pharmaceutical Co., Ltd) 80 mg, qd, on the basis of routine treatment. On the basis of routine treatment, the sacubitril valsartan group took sacubitril valsartan sodium tablets (50 mg/tablet, Beijing Novartis Pharmaceutical Co., Ltd), the initial dose was 25 mg, bid, and gradually increased to the target dose according to the patient's blood pressure. After 12 months of treatment, the independent sample t test showed that the left ventricular end diastolic dimension in the sacubitril valsartan group was lower than that in the valsartan group [(47.26 ± 4.71) mm vs (50.05 ± 5.62) mm, P < .001]. The left ventricular ejection fraction in the sacubitril valsartan group was higher than that in the valsartan group [(54.76 ± 4.24)% vs (49.28 ± 3.74)%, P < .001]. χ2 inspection showed that the readmission rate in the sacubitril valsartan group was lower than that in the valsartan group (7.14% vs 18.60%, P < .05). Sacubitril valsartan has good safety and tolerability in patients with diabetes mellitus complicated with AMI who have HF with midrange ejection fraction. Compared with valsartan, sacubitril valsartan can improve the left ventricular function better and reduce the readmission rate due to HF in these patients.

摘要

目的 评估沙库巴曲缬沙坦治疗急性心肌梗死后伴射血分数中间值的心力衰竭(HF)合并糖尿病患者的临床疗效和安全性。 方法 回顾性分析 2015 年 1 月至 2020 年 7 月我院 HF 合并糖尿病并发 AMI 患者,根据用药分为沙库巴曲缬沙坦组(84 例)和缬沙坦组(86 例)。缬沙坦组在常规治疗基础上加用缬沙坦胶囊(80mg/粒,北京诺华制药有限公司)80mg,qd。沙库巴曲缬沙坦组在常规治疗基础上加用沙库巴曲缬沙坦钠片(50mg/片,北京诺华制药有限公司),初始剂量 25mg,bid,根据患者血压逐渐增加至目标剂量。 结果 两组患者一般资料比较差异无统计学意义(P>0.05)。两组患者治疗后左心室舒张末期内径(LVEDD)均较治疗前降低,左心室射血分数(LVEF)均较治疗前升高(P<0.05),且治疗后沙库巴曲缬沙坦组 LVEDD 低于缬沙坦组,LVEF 高于缬沙坦组(P<0.05)。沙库巴曲缬沙坦组不良反应发生率为 7.14%,缬沙坦组为 18.60%,两组比较差异有统计学意义(P<0.05)。 结论 沙库巴曲缬沙坦治疗 HF 合并糖尿病并发 AMI 患者具有良好的安全性和耐受性,与缬沙坦比较,能更好地改善左心室功能,降低 HF 再住院率。

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