摘要
目的 观察沙库巴曲缬沙坦(ARNI)对左室射血分数(LVEF)降低的扩张型心肌病(DCM)病人炎症因子及预后的影响.方法 选取于潍坊市益都中心医院治疗的符合纳入和排除标准的200例DCM病人,采用区组随机化法将病人分为观察组(常规治疗加ARNI片)和对照组(常规治疗),每组100例.比较治疗6个月后两组病人的临床疗效、白细胞介素6(IL-6)、基质金属蛋白酶2(MMP-2)、半乳糖凝集素3(Gal-3)、LVEF、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)及心房颤动控制情况;比较1年后两组病人的并发症及DCM再入院情况.结果 观察组的临床疗效优于对照组(Z=2.936,P=0.003),IL-6、MMP-2、Gal-3治疗后水平及治疗前后降低幅度均优于对照组(t=3.421～11.593,P＜0.01),LVEF、LVEDD、LVESD治疗后水平及治疗前后的改善幅度均优于对照组(t=4.817～10.326,P＜0.01),心房颤动控制优于对照组(Z=4.223,P＜0.001),1年后的并发症发生率和再入院率均低于对照组(x2=10.976、21.597,P＜0.001).结论 ARNI对于射血分数降低的DCM病人的预后影响比较显著,有效改善了心脏结构且减轻了心室重塑,提高了病人的生活质量.
Abstract
Objective To investigatethe effect of sacubitril/valsartan(ARNI)on inflammatory factors and prognosis in pa-tients with dilated cardiomyopathy(DCM)with reducedleft ventricular ejection fraction(LVEF).Methods A total of 200 pa-tients who were treated in Yidu Central Hospital of Weifang and met the inclusion and exclusion criteria were enrolled and divided into observation group(conventional treatment with ARNI tablets)and control group(conventional treatment)using the block randomization method,with 100 patients in each group.The two groups were compared in terms of clinical outcome,interleukin-6(IL-6),matrix metalloproteinase-2(MMP-2),galectin 3(Gal-3),LVEF,left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),and control of atrial fibrillation after 6 months of treatment,as well as complications and readmission due to DCM after 1 year.Results The observation group had a significantly better clinical outcome than the control group(Z=2.936,P=0.003).Compared with the control group,the observation group had significantly better levels of IL-6,MMP-2,and Gal-3 and significantly greater reductions after treatment(t=3.421-11.593,P＜0.01).Compared with the con-trol group,the observation group had significantly better LVEF,LVEDD,and LVESD and significantly greater improvements in these indices after treatment(t=4.817-10.326,P＜0.01),as well as a significantly better control of atrial fibrillation(Z=4.223,P＜0.001).Compared with the control group,the observation group had significantly lower incidence rate of complications and re-admission rate(X2=10.976,21.597,P＜0.001).Conclusion ARNI has a significant effecton the prognosis of DCM patients with reduced ejection fraction and can effectively improve cardiac structure,alleviate ventricular remodeling,and enhance the quali-ty of life of patients.
基金项目
潍坊市卫生局项目(WFWSJK-2020-283)
维普
万方数据