目的 探讨腹膜透析(peritoneal dialysis,PD)合并慢性心功能不全患者采用沙库巴曲缬沙坦治疗的效果和对氨基末端脑钠肽前体(N terminal pro B type natriuretic peptide,NT-proBNP)、血肌酐(serum creatinine,Scr)、肾小球滤过率(estimated glomerular filtration rate,eGFR)的影响.方法 前瞻性随机选取2023年1-12月徐州医科大学附属医院行规律治疗的PD合并慢性心功能不全患者82例为研究对象,依据治疗方法不同分为对照组与观察组,各41例.对照组施以常规治疗,观察组联合沙库巴曲缬沙坦,比较两组临床疗效、心功能、NT-proBNP、肾功能及不良反应发生情况.结果 观察组治疗总有效率为97.56%(40/41),高于对照组的85.36%(35/41),差异有统计学意义(χ2=3.904,P=0.048).治疗后观察组左室收缩末期内径(left ventricular end systolic diameter,LVESD)、左心室舒张末期内径(left ventricular end diastolic dimension,LVEDD)、NT-proBNP水平低于对照组,左心射血分数(left ventricular ejection fractions,LVEF)水平高于对照组,差异有统计学意义(P均<0.05).治疗后两组Scr、eGFR水平提高,尿素氮水平下降,但两组组间比较,差异无统计学意义(P均>0.05).两组不良反应发生率对比,差异无统计学意义(P>0.05).结论 对PD合并慢性心功能不全患者施以沙库巴曲缬沙坦治疗,临床效果显著,能在一定程度上促进患者NT-proBNP水平的改善,同时不会对患者肾功能产生不利影响.
Efficacy of Sacubitril Valsartan on Peritoneal Dialysis Patients with Chronic Heart Failure and Its Effect on NT-proBNP,Serum Creatinine and Glomerular Filtration Rate
Objective To investigate the effect of sacubitril valsartan on patients with peritoneal dialysis(PD)compli-cated with chronic cardiac insufficiency and its effect on N terminal pro B type natriuretic peptide(NT-proBNP),se-rum creatinine(Scr),estimated glomerular filtration rate(eGFR).Methods A total of 82 patients with PD complicated with chronic cardiac insufficiency who received regular treatment in the Affiliated Hospital of Xuzhou Medical Univer-sity from January to December 2023 were prospective randomly selected as the research objects.They were divided into control group and observation group according to the different treatment methods,with 41 cases in each group.The control group was given routine treatment,and the observation group was combined with sacubitril valsartan.Com-pared the clinical efficacy,cardiac function,NT-proBNP,renal function and adverse reactions of the two groups.Re-sults The total effective rate of the observation group was 97.56%(40/41),which was higher than 85.36%(35/41)of the control group,and the difference was statistically significant(χ2=3.904,P=0.048).Aftr treatment,the levels of left ventricular end systolic diameter(LVESD),left ventricular end diastolic dimension(LVEDD)and NT-proBNP of the observation groups were lower than those in the control group,and the level of left ventricular ejection fractions(LVEF)was higher than that in the control group,the differences were statistically significant(all P<0.05).After treat-ment,the levels of Scr and eGFR in the two groups increased,and the level of urea nitrogen decreased,but there was no significant difference between the two groups(all P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The treatment of PD combined with chronic cardiac in-sufficiency with sacubitril valsartan is clinically effective and can promote the improvement of patients'NT-proBNP levels to a certain extent,without adversely affecting their renal function.
Peritoneal dialysisSacubitril valsartanCardiac insufficiencyCurative effectN-terminal pro B type natriuretic peptideSerum creatinine
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维普
