沙库巴曲缬沙坦联合螺内酯治疗慢性射血分数降低心力衰竭的效果

Effect of Shakubatroxartan Combined with Spironolactone on the Treatment of Chronic Ejection Fraction Decreased Heart Failure

摘要: 目的：探讨沙库巴曲缬沙坦联合螺内酯治疗慢性射血分数降低心力衰竭的临床效果及安全性。方法：选取2023年1月至2025年5月收治的48例HFrEF患者，随机分为对照组(ACEI/ARB + 螺内酯治疗)和观察组(沙库巴曲缬沙坦联合螺内酯治疗)，每组24例。比较两组治疗前后心功能指标、血清标志物、NYHA改善和总体疗效及不良事件发生率。结果：观察组左心室射血分数提升(42.3% ± 6.1% vs 36.8% ± 5.2%, P < 0.05)、6分钟步行距离增加(387.5 ± 58.6 m vs 328.7 ± 52.4 m, P < 0.05)、NT-proBNP水平降低(985 ± 387 pg/mL vs 1568 ± 542 pg/mL, P < 0.05)均优于对照组。临床总有效率观察组达91.67%，显著高于对照组的70.83% (P < 0.05)。观察组与对照组不良反应发生率无明显统计学差异(P > 0.05)。结论：沙库巴曲缬沙坦联合螺内酯可显著改善HFrEF患者心功能，提高运动耐量，降低神经内分泌激活水平，且安全性良好。

Abstract: Objective: To explore the clinical effect and safety of Shakubatrivasartan combined with spironolactone in the treatment of chronic heart failure with reduced ejection fraction. Methods: Forty-eight patients with HFrEF from January 2023 to May 2025 were randomly divided into control group (treated with spironolactone) and observation group (treated with Shakubatrivasartan combined with spironolactone), with 24 patients in each group. The improvement of cardiac function index, serum markers, NYHA, overall curative effect and incidence of adverse events were compared between the two groups before and after treatment. Results: In the observation group, the left ventricular ejection fraction increased (42.3% ± 6.1% vs 36.8% ± 5.2%, P < 0.05), the 6-minute walking distance increased (387.5 ± 58.6 m vs 328.7 ± 52.4 m, P < 0.05) and the level of NT-proBNP decreased (985 ± 387 pg/mL vs 1568 ± 542 pg/mL, P < 0.05). The total clinical effective rate in the observation group was 91.67%, which was significantly higher than that in the control group (70.83%, P < 0.05). There was no significant statistical difference in the incidence of adverse reactions between the observation group and the control group (P > 0.05). Conclusion: Shakubatroxartan combined with spironolactone can significantly improve cardiac function, increase exercise tolerance and reduce neuroendocrine activation level in patients with HFrEF, and it is safe.