沙库巴曲缬沙坦钠片对老年慢性心力衰竭伴焦虑抑郁病人心功能及神经递质指标的影响

doi:10.3969/j.issn.1003-9198.2025.08.008

摘要/Abstract

摘要： 目的观察沙库巴曲缬沙坦钠片(ARNI)对老年慢性心力衰竭(CHF)伴焦虑抑郁病人心功能及神经递质指标的影响。方法选取2021年1月至2023年12月我院收治的120例老年慢性CHF伴焦虑抑郁的病人为研究对象,随机分为观察组(60例)和对照组(60例),对照组服用常用治疗CHF药物,包括呋塞米、血管紧张素转换酶抑制剂、琥珀酸美托洛尔缓释片、螺内酯,观察组服用ARNI、呋塞米、琥珀酸美托洛尔缓释片、螺内酯,疗程均为3个月。观察并比较2组治疗前后焦虑抑郁量表评分、纽约心脏协会(NYHA)心功能分级疗效、6 min步行距离(6MWD)、明尼苏达CHF生活质量问卷(MLHFQ)评分、超声心动图指标[左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、LVEF]、血清N末端B型脑钠肽前体(NT-proBNP)、5-羟色胺(5-HT)、多巴胺(DA)、去甲肾上腺素(NE)等神经递质水平。结果观察组治疗后,焦虑抑郁量表评分、NYHA心功能分级、6MWD、MLHFQ、LVEDD、LVESD、LVEF、NT-proBNP、5-HT、DA、NE等水平和生活质量明显优于对照组(P<0.05)。结论 ARNI可提高老年CHF的临床疗效,改善心功能和生活质量,纠正焦虑抑郁,其可能机制与提高神经递质水平、减轻心肌氧化应激损伤、改善抗氧化能力、延缓心肌重构有关。

关键词: 沙库巴曲缬沙坦钠片, 慢性心力衰竭, 焦虑抑郁, 神经递质, 心肌重构, 老年人

Abstract: Objective To investigate the effects of sacubitril valsartan sodium tablets (ARNI) on cardiac function and neurotransmitter indicators in the elderly patients with chronic heart failure (CHF) complicated with anxiety and depression. Methods A total of 120 elderly patients with CHF complicated with anxiety and depression admitted to our hospital from January 2021 to December 2023 were enrolled. They were randomly divided into observation group (60 cases) and control group (60 cases). The control group received conventional treatment for heart failure (furosemide, angiotensin-converting enzyme inhibitor, metoprolol succinate sustained-release tablets, and spironolactone), while the observation group received ARNI, furosemide, metoprolol succinate sustained-release tablets, and spironolactone. The treatment duration was 3 months in both groups. The score of anxiety and depression scale, New York Heart Association (NYHA) cardiac function classification, 6-minute walk distance (6MWD), the score of Minnesota Living with Heart Failure Questionnaire (MLHFQ), the levels of the echocardiographic indicators such as left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF), the levels of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP), and serotonin (5-HT), dopamine (DA), and norepinephrine (NE) were compared between the two groups. Results After treatment, the observation group showed significantly better outcomes in the score of anxiety and depression scale, NYHA cardiac function classification, 6MWD, the score of MLHFQ, the levels of echocardiographic parameters (LVEDD, LVESD, LVEF), NT-proBNP, and neurotransmitters (5-HT, DA, NE) compared to the control group (P<0.05). Conclusions ARNI, when routinely used in the treatment of elderly patients with CHF complicated with anxiety and depression, can improve clinical efficacy, cardiac function and life quality, and alleviate anxiety and depression. The potential mechanisms may be related to increased neurotransmitter levels, reduced myocardial oxidative stress damage, improved antioxidant capacity, and delayed myocardial remodeling.

Key words: sacubitril valsartan sodium tablets, chronic heart failure, anxiety and depression, neurotransmitter, myocardial remodeling, aged

中图分类号:

R541.6

黄春辉, 张伟, 郑永宏, 林松. 沙库巴曲缬沙坦钠片对老年慢性心力衰竭伴焦虑抑郁病人心功能及神经递质指标的影响[J]. 实用老年医学, 2025, 39(8): 793-797.

HUANG Chunhui, ZHANG Wei, ZHENG Yonghong, LIN Song. Effects of sacubitril valsartan sodium tablets on cardiac function and neurotransmitters in elderly patients with chronic heart failure complicated with anxiety and depression[J]. Practical Geriatrics, 2025, 39(8): 793-797.

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