Study on the effect of sacubitril-valsartan in the treatment of hemodialysis patients with chronic heart failure with reduced ejection fraction
Objective To explore the efficacy of sacubitril-valsartan in the treatment of hemodialysis(HD)patients with chronic heart failure with reduced ejection fraction(HFrEF).Methods A total of 30 hemodialysis patients with chronic HFrEF were allocated into a control group and an experimental group according to different treatment methods,each comprising of 15 patients.Both groups were treated with conventional HD and basic medication.Meanwhile,the control group received benazepril tablets,while the study group was administered sacubitril/valsartan sodium tablets.Both groups underwent continuous medication for 6 months.Both groups were compared in terms of left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),N-terminal pro-B-type natriuretic peptide(NT-proBNP),and blood potassium levels.Results(i)Intragroup comparison:compared with the control group before treatment,LVEF increased,LVEDD and NT-proBNP decreased after 3 and 6 months of treatment(P<0.05).There was no difference in LVEF,LVEDD,and NT-proBNP in the control group at 6 months of treatment compared with this group at 3 months of treatment(P>0.05).LVEF increased and LVEDD and NT-proBNP decreased in the study group at 3 and 6 months of treatment compared with those before treatment in this group(P<0.05).Compared with those at 3 months after treatment,there was no significant change in LVEF and LVEDD in the study group after 6 months of treatment(P>0.05),and the NT-proBNP of the study group decreased after 6 months of treatment(P<0.05).Comparison between groups:LVEF of the study group were(47.63±5.03)%and(48.17±5.16)%after 3 and 6 months of treatment,which were higher than(41.79±4.19)%and(42.28±4.37)%of the control group;LVEDD were(52.63±3.81)and(51.02±3.49)mm,which were smaller than(56.47±4.01)and(55.72±4.13)mm of the control group;NT-proBNP were(17916.25±5126.40)and(13152.73±5093.37)pg/ml,which were lower than(24776.63±6609.51)and(23942.45±6393.51)pg/ml of the control group(P<0.05).(ii)Compared with before treatment,there was no change in blood potassium in the two groups after 2,4 and 6 months of treatment(P>0.05).Comparison between groups:after 2,4 and 6 months of treatment,there was no difference in serum potassium level between the two groups(P>0.05).Conclusion Sacubactril-valsartan can be used in the treatment of heart failure in HD patients with chronic HFrEF,and the efficacy is better than benazepril,which has high clinical application value.
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