临床误诊误治2025，Vol.38Issue(20)：28-32,5.DOI:10.3969/j.issn.1002-3429.2025.20.005
不同剂量沙库巴曲缬沙坦钠对心房颤动合并射血分数保留型心力衰竭患者血清ET-1、FGF23及心力衰竭再入院风险的影响
Impact of different doses of Sacubitril/Valsartan Sodium on serum ET-1,FGF23 and the risk of readmission due to heart failure in patients with atrial fibrillation complicated with heart failure with preserved ejection fraction
摘要
Abstract
Objective To investigate the effects of different doses of Sacubitril/Valsartan Sodium on the levels of serum endothelin-1(ET-1)and fibroblast growth factor 23(FGF23)and the risk of readmission for heart failure in patients with atrial fibrillation(AF)complicated with heart failure with preserved ejection fraction(HFpEF).Methods A total of 94 patients with AF complicated with HFpEF who were admitted from January 2021 to January 2023 were selected and divided into the observation group(n=47)and the control group(n=47)according to the random number table method.The control group was given basic treatment combined with Sacubitril/Valsartan Sodium 50 mg orally twice a day,and the medication was withdrawn after maintenance treatment for 3 months.The observation group was given basic treatment combined with Sacubitril/Valsartan Sodium 50 mg twice daily,and then the dosage was increased weekly to a maximum of 200 mg twice daily for oral administration.The treatment was continued for 3 months and then the drug was discontinued.The levels of left ventricular ejection fraction(LVEF),left ventricular fractional shortening(FS),left ventricular end-diastolic diameter(LVEDD),serum ET-1,FGF23,N-terminal pro-B-type natriuretic peptide(NT-ProBNP)and 6-minute walking distance(6MWD),the Minnesota Living with Heart Failure Questionnaire(MLHFQ)score before treatment and at 1 d after the end of the treatment course,as well as the incidence of adverse events during treatment and the readmission rate for heart failure at 6-month follow-up were compared between the two groups.Results After treatment,LVEF and FS in both groups were increased compared with those before treatment,and LVEDD was decreased compared with that before treatment(P<0.05).After treatment,compared with the control group,LVEF and FS in the observation group increased,while LVEDD decreased(P<0.01).After treatment,the levels of serum ET-1,FGF23 and NT-ProBNP in both groups decreased,which were lower in the observation group than in the control group(P<0.05,P<0.01).After treatment,the 6MWD of both groups was prolonged and the MLHFQ score was decreased.Moreover,the 6MWD of the observation group was longer than that of the control group,and the MLHFQ score was lower than that of the control group(P<0.05,P<0.01).No patients developed hyperkalemia in either group during the treatment period.The total incidence of adverse events in the observation group during the treatment period was 19.15%,which was significantly higher than 4.26%in the control group(P<0.05).There was no significant difference in the readmission rate due to heart failure between the two groups at 6-month follow-up(P>0.05).Conclusion High-dose Sacubitril/Valsartan sodium treatment can reduce the levels of serum ET-1 and FGF23 in patients with atrial fibrillation complicated with HFpEF,and improve exercise tolerance and quality of life;however,it has a limited effect on improving the risk of readmission due to heart failure.关键词
心房颤动/射血分数保留型心力衰竭/沙库巴曲缬沙坦钠/内皮素-1/纤维细胞生长因子23/N末端B型利钠肽前体Key words
atrial fibrillation/heart failure with preserved ejection fraction/Sacubitril/Valsartan sodium/endothelin-1/fibroblast growth factor 23/N-terminal B-type natriuretic peptide precursor引用本文复制引用
师淼,冯倩,陈素艳,杜佩珊,高博..不同剂量沙库巴曲缬沙坦钠对心房颤动合并射血分数保留型心力衰竭患者血清ET-1、FGF23及心力衰竭再入院风险的影响[J].临床误诊误治,2025,38(20):28-32,5.基金项目
2021年度河北省医学科学研究课题计划项目(20211610) （20211610）
