重组人脑利钠肽、沙库巴曲缬沙坦、托伐普坦序贯治疗高龄射血分数降低的心力衰竭病人的疗效观察

doi:10.3969/j.issn.1003-9198.2021.09.016

Abstract

Abstract: Objective To investigate the curative effect of sequential treatment of recombinant human brain natriuretic peptide, sacubitril/valsartan and tolvaptan on the elderly patients with heart failure with reduced ejection fraction (HFrEF). Methods A total of 40 patients with HFrEF aged 80 to 90 years old were randomly divided into conventional treatment group and sequential treatment group,with 20 cases in each group. The patients in conventional treatment group were treated with conventional anti-heart failure drugs. The patients in sequential treatment group were sequentially treated with recombinant human brain natriuretic peptide, sacubitril/valsartan and tolvaptan on the basis of stopping angiotensin converting enzyme inhibitor (ACEI)/angiotensin Ⅱ receptor blocker (ARB). Minnesota Living with Heart Failure Questionnaire (MLHFQ) and 6-minute walking test (6MWT) were used to evaluate the cardiac function of the patients, and cardiac color Doppler ultrasound was used to detect the left ventricular ejection fraction (LVEF), cardiac output (CO) and stroke volume (SV) of the patients. Additionally, the levels of plasma brain natriuretic peptide (BNP), renal function and serum electrolytes were also detected. Results After 10 days of treatment, the total effective rate of sequential treatment group was significantly higher than that of conventional treatment group (P＜0.05);The MLHFQ score, 6MWT distance, and the levels of LVEF, CO, SV and plasma BNP in both groups were all improved (P＜0.05), especially in sequential treatment group (P<0.05); The serum levels of K⁺ and Na⁺ in conventional treatment group were significantly lower than those before treatment (all P＜0.05), whereas there were no significant differences in the serum electrolytes levels of sequential treatment group after treatment (all P＞0.05). In addition, there was no significant change in renal function of both groups after treatment (all P＞0.05). Conclusions The sequential treatment of recombinant human brain natriuretic peptide, sacubitril/valsartan and tolvaptan could improve the cardiac function of the elderly patients with HFrEF effectively.

Key words: recombinant human brain natriuretic peptide, sacubitril/valsartan, tolvaptan, aged, heart failure

CLC Number:

R 541.6

QUAN Qian-kun, FENG Jian-jun, LI Xi, LI Wan-ni, ZHANG Xiu-li, LIU Chun-tian. Effect of sequential treatment of recombinant human brain natriuretic peptide, sacubitril/valsartan and tolvaptan on elderly patients with heart failure with reduced ejection fraction[J]. Practical Geriatrics, 2021, 35(9): 957-961.

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Effect of sequential treatment of recombinant human brain natriuretic peptide, sacubitril/valsartan and tolvaptan on elderly patients with heart failure with reduced ejection fraction

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