摘要
目的:探讨沙库巴曲缬沙坦联合辛伐他汀对射血分数保留型心力衰竭(HFpEF)患者心功能、心室重构以及血清半乳糖凝集素-3(Gal-3)、可溶性生长刺激表达基因2蛋白(sST2)水平的影响.方法:选取2020年6月～2021年6月上海健康医学院附属崇明医院收治的HFpEF患者120例,按照随机数表法分为对照组(采用辛伐他汀治疗)和联合治疗组(采用沙库巴曲缬沙坦联合辛伐他汀治疗),每组60例.连续治疗6个月,对比两组心功能、心室重构、血清指标及6个月随访情况.结果:治疗后与对照组比较,联合治疗组左心室收缩末期内径(LVESd)、左心室舒张末期内径(LVEDd)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)均显著减小,左心室质量指数(LVMI)、Gal-3、sST2、N末端脑钠肽前体(NT-proBNP)、肾素、血管紧张素Ⅱ(Ang Ⅱ)水平均显著降低,6min步行距离(6MWD)显著增加(P＜0.05或＜0.01).两组再住院率和死亡率差异无统计学意义(P均＞0.05).结论:沙库巴曲缬沙坦联合辛伐他汀能够有效改善HFpEF患者的心功能和心室重构,降低血清Gal-3、sST2水平,延缓病情进展.
Abstract
Objective:To investigate the effects of sacubitril valsartan combined with simvastatin on cardiac function,ventricular remodeling,serum levels of Gelectin-3(Gal-3)and soluble growth stimulation expressed gene 2(sST2)in patients with heart failure with preserved ejection fraction(HFpEF).Methods:This randomized con-trolled study enrolled 120 HFpEF patients admitted Affiliated Chongming Hospital of Shanghai University of Medi-cine & Health Sciences between June 2020 and June 2021.They were divided into control group(n=60,simvastatin therapy)and combined treatment group(n=60,additional sacubitril valsartan based on control group),and treated for continuous 6 months.Cardiac function,ventricular remodeling,serum indexes and 6-month follow-up out-come were compared between two groups.Results:Compared with patients in control group after treatment,those in combined treatment group had significant lower left ventricular end-systolic diameter(LVESd),left ventricular end-diastolic diameter(LVEDd),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular mass index(LVMI),levels of Gal-3,sST2,N terminal pro brain natriuretic peptide(NT-proBNP),renin and angiotensin Ⅱ(Ang Ⅱ),and significant higher 6min walking distance(6MWD)(P＜0.05 or＜0.01).There were no significant difference in rehospitalization rate and mortality between two groups(P＞0.05 both).Conclusion:Sacubitril valsartan combined with simvastatin can effectively improve cardiac function and ventricular remodeling,reduce serum levels of Gal-3 and sST2,and delay the progression of disease in HFpEF patients.
维普
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