沙库巴曲缬沙坦治疗不同类型慢性心力衰竭的临床疗效观察和安全性初探

沙库巴曲缬沙坦治疗不同类型慢性心力衰竭的临床疗效观察和安全性初探摘要：目的：探讨沙库巴曲缬沙坦治疗不同类型慢性心力衰竭的疗效和安全性。

方法：选取2018年1月至2021年1月在我院住院治疗的不同类型慢性心力衰竭患者100例，随机分为观察组和对照组各50例。观察组在常规治疗基础上加用沙库巴曲缬沙坦，对照组仅进行常规治疗。分别在治疗前后比较两组患者心功能分级、心功能指数、6分钟步行试验距离、住院时间、并发症和不良反应等指标。

结果：观察组在治疗后心功能分级、心功能指数、6分钟步行试验距离均有显著改善，住院时间显著缩短，并发症和不良反应发生率较低，与对照组相比差异有统计学意义。

结论：沙库巴曲缬沙坦可以有效改善不同类型慢性心力衰竭患者的心功能，提高生活质量，且安全性较高，可作为一种常规治疗手段。关键词：沙库巴曲缬沙坦；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