| Objective:The purpose of this study is to analyse the efficacy and safety of low dose sacubitril/valsartan and ACEI/ARB in the treatment of patients with chronic heart failure,by comparing the changes of corresponding clinical indicators and the occurrences of adverse reactions and adverse cardiovascular events before using the medicine and 6 months after treatment.Methods:From October 2017 to June 2019,66 cases of patients who hospitalized in our hospital for chronic heart failure were enrolled.All patients were randomly divided into experimental group(35 cases in the Sacubitril Valsartan group)and control group(31cases in the ACEI/ARB group).The experimental group was treated with sacubitril/valsartan 25 mg orally twice a day.The control group was treated with ACEI/ARB,if the patient was tolerant,the medicine dose would be doubled until target dose.Else,if the patient was intolerant,than maintain the tolerated maximum dose.Both of two groups acquired the same conventional drugs including cardiac stimulant,diuretics,?-blockers and other conventional drugs for anti-heart.Before and 6 months after the treatment,patients'blood pressure,heart rate,serum K~+,Scr,NT-pro BNP,6-MWT,MLHFQ,echocardiogram(LAD,LVEDD,IVS,LVEF)were measured,and further more,follow-up and record of adverse reactions and adverse cardiovascular events were finished.Results:1.Comparison of the general situation between experimental group and control group is similar,there were no statistically significant differences in age,gender,blood pressure,heart rate,serum K~+,Scr,NT-pro BNP,NYHA class,cause of heart failure,6-MWT,MLHFQ,LAD,LVEDD,IVS,LVEF between the two groups(all P>0.05).2.After 6 months of treatment,in both of the two groups,systolic pressure is reduced to compare with those before treatment,experimental group(120.71±17.80 vs114.66±15.53,P=0.034),control group(126.81±14.76 vs 118.36±13.15,P<0.01),MLHFQ is improved,experimental group:(45.03±22.33 vs 27.86±20.33,P<0.01),control group:(38.06±16.98 vs 29.35±17.16,P<0.01),6-MWT distance is increased,experimental group:(385.87±84.69 vs 450.22±86.02,P<0.01),control group:(370.61±117.47 vs 422.74±118.84,P<0.01),the differences are statistically significant(all P<0.05),but there is no statistical difference between two groups(P>0.05).After 6 months of treatment,serum K~+in experimental group is increased(4.07±0.34 vs 4.41±0.43,P<0.01),NT-pro BNP is improved(2056(1135,4075)vs 1902(376,3036),p=0.047),the difference is statistically significant(P<0.05).After 6months of treatment,Scr of the two groups is no difference(P>0.05).After 6 months of treatment,two groups can improve the LVEF values,experimental group:(34.85±8.79vs 39.11±12.09,P=0.012),control group(36.99±9.98 vs 42.11±10.5,P=0.044).LAD in control group is reduced(48.14±7.78 vs 45.38±6.82,P=0.009),the difference is statistically significant(P<0.05).LVEDD in control group is reduced(P=0.082),but the difference is no statistically significant(P=0.082).IVS of the two groups is no difference(P>0.05).3.In the respect of drug adverse reactions and adverse cardiovascular events,experimental group and control group are similar between the two groups,there is no significant differences(P>0.05).Conclusions:Low dose Sacubitril/valsartan can effectively improve the quality of life,increase the endurance for patients with chronic heart failure.So it's safe and effective as same as ACEI/ARB. |
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