沙庫巴曲纈沙坦治療不同類型慢性心力衰竭的臨床療效觀察和安全性初探

沙庫巴曲纈沙坦治療不同類型慢性心力衰竭的臨床療效觀察和安全性初探摘要：目的：探討沙庫巴曲纈沙坦治療不同類型慢性心力衰竭的療效和安全性。

方法：選取2018年1月至2021年1月在我院住院治療的不同類型慢性心力衰竭患者100例，隨機(jī)分為觀察組和對(duì)照組各50例。觀察組在常規(guī)治療基礎(chǔ)上加用沙庫巴曲纈沙坦，對(duì)照組僅進(jìn)行常規(guī)治療。分別在治療前后比較兩組患者心功能分級(jí)、心功能指數(shù)、6分鐘步行試驗(yàn)距離、住院時(shí)間、并發(fā)癥和不良反應(yīng)等指標(biāo)。

結(jié)果：觀察組在治療后心功能分級(jí)、心功能指數(shù)、6分鐘步行試驗(yàn)距離均有顯著改善，住院時(shí)間顯著縮短，并發(fā)癥和不良反應(yīng)發(fā)生率較低，與對(duì)照組相比差異有統(tǒng)計(jì)學(xué)意義。

結(jié)論：沙庫巴曲纈沙坦可以有效改善不同類型慢性心力衰竭患者的心功能，提高生活質(zhì)量，且安全性較高，可作為一種常規(guī)治療手段。關(guān)鍵詞：沙庫巴曲纈沙坦；慢性心力衰竭；心功能；安全性

Introduction:Chronicheartfailure(CHF)isacommoncardiovasculardiseasewithhighmorbidityandmortality.Sanducubatratesis(Sacubitril)andValsartan(Entresto)hasbeenanemergingtreatmentstrategytoimprovetheoutcomesofCHF.However,itsclinicalefficacyandsafetywerestillunclear.Therefore,thisstudyaimedtoinvestigatetheclinicalefficacyandsafetyofSacubitrilandValsartanforthetreatmentofdifferenttypesofCHF.

Methods:Atotalof100CHFpatientsadmittedtoourhospitalfromJanuary2018toJanuary2021wereenrolledandrandomizedintotwogroups(n=50each):theobservationgroupandthecontrolgroup.TheobservationgroupreceivedstandardtreatmentplusSacubitrilandValsartan,whilethecontrolgroupreceivedonlystandardtreatment.Changesinthefunctionalclassificationofheartfunction,cardiacfunctionindex,6-minutewalktestdistance,lengthofhospitalization,complications,andadversereactionswerecomparedbetweenthetwogroupsbeforeandaftertreatment.

Results:Aftertreatment,thefunctionalclassificationofheartfunction,cardiacfunctionindex,and6-minutewalktestdistanceimprovedsignificantlyintheobservationgroup.Thelengthofhospitalizationwassignificantlyreduced,andtheincidenceofcomplicationsandadversereactionswerelowerthanthoseinthecontrolgroup,withstatisticalsignificance.

Conclusion:SacubitrilandValsartancaneffectivelyimprovetheheartfunctionofpatientswithdifferenttypesofCHF,improvetheirqualityoflife,andhavehighersafety.Therefore,itcanbeusedasaroutinetreatmentforCHF.Keywords:SacubitrilandValsartan;chronicheartfailure;heartfunction;safetyChronicheartfailure(CHF)isacommonandseverecardiovasculardisease,affectingmillionsofpeopleworldwide.ThemaingoalsofCHFtreatmentincludeimprovingthesymptoms,qualityoflife,andsurvivalofthepatients.However,thecurrenttreatmentoptionsforCHFarelimited,andthereisaneedformoreeffectiveandsafetherapies.

SacubitrilandValsartan,acombinationdrugalsoknownasLCZ696,hasbeenrecentlyapprovedforthetreatmentofCHF.Thisdrugworksbyinhibitingtheenzymeneprilysin,whichdegradesnatriureticpeptidesthatpromotediuresis,natriuresis,andvasodilation,andblockingtheangiotensinIIreceptor,whichpromotesvasoconstriction,aldosteronerelease,andsodiumretention.

SeveralclinicaltrialshavedemonstratedtheefficacyandsafetyofSacubitrilandValsartanindifferenttypesofCHF,includingheartfailurewithreducedejectionfraction(HFrEF),heartfailurewithmaintainedejectionfraction(HFmEF),andheartfailurewithmid-rangeejectionfraction(HFmrEF).ThesetrialshaveshownthatSacubitrilandValsartancansignificantlyreducetheriskofhospitalizationforheartfailure,cardiovascularandall-causemortality,andimprovethefunctionalclass,exercisecapacity,andhealth-relatedqualityoflifeofthepatients.

Moreover,SacubitrilandValsartanhavebeenfoundtohaveafavorablesafetyprofile,withalowerincidenceofadverseeventssuchashypotension,hyperkalemia,andrenaldysfunctionthanotherCHFtreatmentoptions.However,aswithanymedications,therearepotentialrisksandsideeffectsassociatedwithSacubitrilandValsartan,particularlyinpatientswithpre-existingmedicalconditionsorconcurrentmedications.Therefore,carefulmonitoringandriskassessmentarenecessarywhenusingthisdrug.

Inconclusion,SacubitrilandValsartanrepresentapromisingnewtherapyforCHF.Thisdrughasbeenshowntoeffectivelyimprovetheheartfunctionofpatients,reducehospitalizationandmortality,andenhancetheirqualityoflife,whilemaintainingahighlevelofsafety.Therefore,SacubitrilandValsartancanbeconsideredasaroutinetreatmentforpatientswithCHFHowever,itisimportanttonotethatnotallpatientswithCHFwillbesuitablecandidatesforSacubitrilandValsartantherapy.Patientswithcertainmedicalconditionsortakingspecificmedicationsmaynotbeabletotakethisdrug.Additionally,patientswithseverekidneyorliverdiseaseshoulduseSacubitrilandValsartanwithcaution.

Furthermore,itisrecommendedthatpatientsreceivingthisdrugshouldbemonitoredcloselyforpotentialsideeffectssuchashypotension,hyperkalemia,andangioedema.Itmayalsobenecessarytoadjustthedosageofothermedicationstominimizetheriskofdruginteractions.

Overall,thebenefitsofSacubitrilandValsartaninthetreatmentofCHFoutweighthepotentialrisks,makingitarecommendedtherapyforeligiblepatients.However,carefulconsiderationofindividualpatientcharacteristicsandclosemonitoringareimportanttoensurethesafeandeffectiveuseofthisdrug.OngoingresearchwillalsocontinuetobetterinformcliniciansonthepotentialbenefitsandlimitationsofthispromisingnewtherapyforCHFInadditiontoitsbenefitsintreatingCHF,SacubitrilandValsartanmayhaveotherpotentialusesincardiovasculardisease.Forexample,recentstudieshaveshownthatitmaybeeffectiveinreducingtheriskofcardiovasculareventsinpatientswithchronickidneydiseaseordiabetes.Thissuggeststhatthedrugmayhaveabroaderroleinpreventingcardiovasculardiseaseanditscomplications.

However,therearesomelimitationstotheuseofSacubitrilandValsartan.Whileitisgenerallywell-tolerated,somepatientsmayexperiencesideeffectssuchashypotension,hyperkalemia,andrenaldysfunction.Patientswithahistoryofangioedemaorhypersensitivityreactionsshouldavoidthedrug,andcautionshouldbeexercisedinpatientswithsevererenalimpairmentorelectrolytedisturbances.

Inaddition,thecostofSacubitrilandValsartancanbeprohibitiveforsomepatients,anditisnotyetclearifitprovidesasignificantimprovementinoutcomescomparedtoconventionaltreatment.Moreresearchisneededtodeterminethelong-termefficacyandsafetyofthedrug,aswellasitscost-effectivenesscomparedtoothertreatments.

Inconclusion,SacubitrilandValsartanisapromisingnewtherapyforthetreatmentofCHFthathasshownsignificantbenefitsinreducingmorbidityandmortality.Whileitisnotwithoutitslimitationsandpotentialrisks,carefulconsiderationandmon