沙库巴曲缬沙坦对不同病程的慢性心力衰竭患者的疗效评价

孙洁; 陈欣

doi:10.13201/j.issn.1001-1439.2021.10.014

沙库巴曲缬沙坦对不同病程的慢性心力衰竭患者的疗效评价

孙洁¹,
陈欣^2, ,

- 1. 天津医科大学一中心临床学院(天津,300070);
- 2. 天津市第一中心医院心内科

详细信息

通讯作者: 陈欣,E-mail:chenxin966@126.com

中图分类号: R541.6

收稿日期: 2021-04-05

修回日期: 2021-05-11

Efficacy evaluation of sacubitril/valsartan in chronic heart failure patients with different duration

SUN Jie¹,
CHEN Xin^2, ,

- 1. School of Clinical, Tianjin Medical University, Tianjin, 300070, China;
- 2. Department of Cardiology, Tianjin First Central Hospital

More Information

Corresponding author: CHEN Xin, E-mail: chenxin966@126.com

Received Date: 05 April 2021

Revised Date: 11 May 2021

摘要

摘要: 目的:探讨沙库巴曲缬沙坦对不同病程的慢性心力衰竭(心衰)患者的临床疗效及预后是否存在差异。方法:根据纳入及排除标准,选取2019年1月—2019年12月在天津市第一中心医院心内科住院的慢性心衰患者100例,给予沙库巴曲缬沙坦治疗,并根据耐受情况进行剂量调整。按心衰病程将患者分为病程<5年者(A组,68例)与≥5年者(B组,32例)。以治疗3、6及12个月为随访时间点,观察患者心脏结构指标[左室射血分数(LVEF)、左室舒张末期内径(LVEDD)]及预后指标(因心衰症状加重再入院和因心血管疾病死亡事件),并比较两组患者12个月内心脏结构指标变化差异及累积无心衰加重再入院、无心血管死亡及无终点事件生存率。结果:随着时间推移,两组患者LVEDD均呈下降趋势,LVEF均呈上升趋势(P_时间<0.05),除基线外,同时间两组组间比较有统计学差异(P_组间<0.05);两组LVEDD、LVEF的变化趋势比较也具有统计学意义(P_交互<0.05)。两组累积无心衰加重再入院生存率分别为65.7%与15.6%,组间比较差异有统计学差异(χ²=23.115,P<0.05);累积无心血管死亡生存率分别为89.3%与87.4%,组间比较差异无统计学意义(χ²=0.068,P>0.05);无终点事件生存率分别为57.6%与15.6%,组间比较差异有统计学意义(χ²=18.978,P<0.05)。Cox多因素回归分析发现,心衰病程≥5年终点事件发生风险更高(HR:3.544;95%CI:1.933~6.498),年龄(HR:2.461;95%CI:1.169~5.17)也是终点事件发生的危险因素。结论:沙库巴曲缬沙坦更有效逆转短病程心衰患者的心室重构,提高无心衰加重再入院及无终点事件累积生存率,改善患者预后。
- 心力衰竭,慢性 /
- 沙库巴曲缬沙坦 /
- 病程 /
- 疗效 /
- 生存分析
Abstract: Objective: To investigate whether there are differences in the clinical efficacy and prognosis of sacubitril/valsartan in chronic heart failure patients with different duration.Methods: According to the inclusion and exclusion criteria, 100 patients with chronic heart failure who were hospitalized in the Department of Cardiology, Tianjin First Central Hospital from January 2019 to December 2019 were selected to receive sacubitril/valsartan treatment, and the dose was adjusted according to the tolerance. According to the course of heart failure, all patients were divided into <5 years(group A, n=68) and ≥5 years(group B, n=32). The follow-up time points were 3, 6, and 12 months after treatment. The cardiac structural indicators(LVEF, LVEDD) and prognostic indicators(readmission to hospital due to aggravation of heart failure, and death due to cardiovascular diseases) were observed. The 12-month cumulative readmission free survival rate, cumulative cardiovascular death free survival rate, and cumulative end-point event free survival rate were compared between the two groups.Results: LVEDD decreased and LVEF increased over time in both groups(P_time<0.05); Except for baseline, there was a significant difference between the two groups at the same time(P_group<0.05); The changing trend of LVEDD and LVEF between the two groups was also statistically significant(P_interaction<0.05). The cumulative readmission survival rate without exacerbation of heart failure in the two groups was 65.7% and 15.6%, there was a statistical difference between the two groups(χ²=23.115, P<0.05); The cumulative event-free survival was 89.3% and 87.4%, and there was no statistical difference between the two groups(χ²=0.068, P>0.05); The endpoint-free survival rate was 57.6% and 15.6%, there was a statistical difference between the two groups(χ²=18.978, P<0.05). Cox multivariate regression analysis showed that the risk of end events was higher when the course of heart failure was ≥5 years(HR: 3.544; 95%CI: 1.933-6.498), age(HR: 2.461; 95%CI: 1.169-5.17) was also a risk factor for the occurrence of endpoint events.Conclusion: Sacubitril/valsartan is more effective in reversing ventricular remodeling in patients with short heart failure duration, with better efficacy, improving readmission without exacerbation of heart failure and cumulative survival without end point events, and improving the prognosis.
- heart failure,chronic /
- sacubitril/valsartan /
- duration /
- effectiveness /
- survival analysis

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