Clinical Observation Of Different Doses Of Sacubitril Valsartan Sodium Tablets In The Treatment Of Chronic Heart Failure

purpose:To investigate the clinical efficiency and adverse reactions of angiotensin receptor neprilysin inhibitor(ARNI)with different dosage in the treatment of chronic heart failure.methods:Choosed from March 2018 to December 2019,115 cases of patients with chronic heart failure as the research object,using the best treatment of chronic heart failure,including rest,limit salt,limit liquid,diuretics,digitalis preparations,nitrates,?-blockers,and aldosterone receptor antagonist treatment and so on.and adjustment the treatment of plans which are on the basis of the primary diseases appropriately,divided the group of patients according to the different dosage were randomly into the group of 25 mg and the group of 50 mg.Sacubitril Valsartan Sodium Tablets: Oral sacubitril valsartan sodium tablets are on the above basic treatment(the trade name: Entresto),approval number is J201190001,The Manufacturer is novartis singapore pharmaceutical manufacturing private Ltd,The specification is 50mg(24mg Sacubitril/26 mg Valsartan).The treatment dosage is 25 mg and 50 mg twice a day.The diet has nothing to do with it.ACEI ought to be stopped for at least 36 h.In addition,It can be converted to sacubitril valsartan sodium tablets when the patients took into low dosage of ARB.In this study,SPSS 20.0 was used to analyze the clinical efficiency,NT-proBNP,left ventricular ejection fraction(LVEF),left ventricular short axial shortening rate(fractional shortening,FS),left ventricular posterior wall(LVEF)and compared between the two groups after the treatment of 1 month and 3 months.The results indicated that there were no significant differences in NT-proBNP,LVEF,FS and LVPW before treatment in the two groups statistically.The incidence of common adverse reactions during treatment,such as symptomatic,hypotension,angioedema,hyperkalemia and renal insufficiency,were recorded and compared between the two groups.results:There was no vital difference in baseline information between the two groups(P>0.05).Statistical analysis was conducted on the patients of the two groups after the treatment?of 1 month and 3 months respectively.The results showed that compared with NT-proBNP,LVEF,FS and LVPW before the treatment of the two groups,the differences were not statistical significant(8642.76±5789.89vs9029.65±6650.71,336.89±7.97vs36.17±7.15,26.81±2.78vs27.69±4.28,10.36±1.693vs10.28±1.47,P>0.05).After the treatment of 3 months,NT-proBNP in the group of 50 mg was significantly lower than 25mg(5188.77±3145.73vs6394.29±4499.58,P<0.05),After the treatment of 1 month,NT-proBNP in the group of 50 mg was lower than that in the group of 25 mg,LVEF and FS were higher than that in the group of 25 mg,but there were no statistical significant differences(6825.11±4616.46vs8478.60±8082.47,38.01±6.70vs37.95±7.70,25.85±2.98 vs26.51±4.19,P>0.05).After 3 months,LVEF and FS of patients in the group of 50 mg were higher than those in the 25 mg group,(P<0.05).conclusions:1.Compared with the group of 25 mg,the group of 50 mg showe-d a higher clinical response rate,improved LVEF,FS,and lower LVPW,greatly reduced NT-proBNP's levels in CHF patients,which was demonstrating a stronger time compliance and overall efficacy.2.There was no significant difference in the incidence of CHF adverse reaction between the group of 50 mg and the group of 25 mg.