Clinical trial of sacubitril valsartan in the treatment of patients with essential hypertension complicated with chronic heart failure
Objective To explore the effects of sacubitril valsartan tablets combined with furosemide tablets on serum N-terminal pro brain natriuretic peptide(NT-proBNP)and angiotensin Ⅱ(Ang Ⅱ)in patients with primary hypertension(PH)and chronic heart failure(CHF).Methods Patients with PH and CHF were divided into control group and treatment group according to cohort method.The control group was treated with furosemide tablets(20 mg,bid)on basis of routine treatments(sodium restriction,diuresis),while treatment group was treated with sacubitril valsartan tablets(50 mg,bid;increase to 100 mg/once according to tolerance)on basis of control group.All patients were treated for 8 weeks.The clinical curative effect,cardiac function[left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD)],myocardial enzymes[cardiac troponin Ⅰ(cTn Ⅰ),creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LD)],ambulatory blood pressure,serum NT-proBNP and Ang Ⅱwere compared between the two groups.Results There were 47 cases in treatment group and 51 cases in control group,respectively.After treatment,total response rates of treatment group and control group were 87.23％(41 cases/47 cases)and 68.63％(35 cases/51 cases),and the difference was statistically significant(P＜0.05).After treatment,LVEF in treatment group and control group were(43.91±3.64)％and(37.72±3.28)％;LVESD were(43.64±2.29)and(47.88±2.13)mm;LVEDD were(52.47±2.05)and(57.31±2.29)mm;cTnⅠ levels were(0.57±0.18)and(0.86±0.27)μg·L-1;CK-MB levels were(22.93±4.76)and(31.48±5.36)U·L-1;LD levels were(196.82±17.42)and(269.72±19.34)U·L-1;the 24 h average systolic blood pressure were(138.63±1.95)and(140.27±2.41)mmHg;the nighttime mean systolic blood pressure were(133.76±1.84)and(135.73±1.65)mmHg;the nighttime mean diastolic blood pressure were(82.14±1.47)and(83.68±1.55)mmHg;NT-proBNP were(1 041.54±261.73)and(1 695.73±294.58)pg·mL-1;Ang Ⅱ were(47.61±9.62)and(64.39±10.45)pg·mL-1.Compared with the control group,the above indexes in treatment group were statistically significant(all P＜0.05).The adverse drug reactions in the treatment group were headache,dizziness,hypotension and hyperkalemia.The control group mainly had digestive tract discomfort,headache,dizziness,bradycardia,constipation.The incidence of adverse drug reactions was 12.76％in treatment group and 9.80％in control group,with no statistical significance(P＞0.05).Conclusion The clinical curative effect of sacubitril valsartan tablets combined with furosemide tablets is significantly in patients with PH and CHF,which can effectively improve cardiac function,relieve myocardial injury,maintain stability of blood pressure rhythm.
万方数据
维普
