沙库巴曲缬沙坦治疗持续性房颤的临床效果以及对心脏结构的影响

Clinical Effect of Sackubactril and Valsartan in the Treatment of Persistent Atrial Fibrillation and Its Effect on Cardiac Structure

摘要: 目的：观察沙库巴曲缬沙坦治疗持续性房颤的临床效果以及对心脏结构的影响。方法：随机选择2023年1月至2023年12月至我院进行治疗的持续性房颤患者110例，使用随机数字法将患者分为观察组和对照组各55例，分别予以沙库巴曲缬沙坦 + 胺碘酮治疗和单独应用胺碘酮治疗。比较两组患者治疗后14 d电复律比例和随访1年复发率、超声检查治疗前后左心室和左心房结构变化，以及血流动力学变化。结果：观察组患者14 d电复律治疗率、6个月和1年房颤复发率分别为20.00%、10.91%和27.27%，均低于对照组的49.49%、25.45%和58.18% (χ² = 10.292, P = 0.001; χ² = 3.911, P = 0.048; χ² = 10.736, P = 0.001)。两组患者治疗前左心房内径(left anterior descending, LAD)、左心房容积(left atrial volume, LAV)、左心房容积指数(left atrial volume index, LAVI)、左心房存储应变(left atrial strain during reservoir phase, LASr)、左心室射血分数(left ventricular ejection fraction, LVEF)、舒张末期内径(left ventricular end diastolic diameter, LVEDD)、收缩末期内径(left ventricular end systolic diameter, LVESD)水平均无明显差异(P > 0.05)，治疗1年后，两组患者上述指标与治疗前相比均有组内差异(P < 0.05)，但观察组LASr、LVEF高于对照组，其余指标低于对照组(P < 0.05)。两组患者治疗前心率无统计学差异(P > 0.05)，治疗后两组患者心率与治疗前相比均降低(P < 0.05)，且观察组(75.44 ± 7.69)次/min，低于对照组(88.63 ± 8.29)次/min，(t = 8.651; P < 0.001)。结论：沙库巴曲缬沙坦有利于持续性房颤患者恢复窦性心律，长期使用能够帮助患者心脏结构的恢复，降低心率，但是不会影响患者的血压，具有很好的临床应用价值。

Abstract: Objective: To observe the clinical effect of sackubactril valsartan in the treatment of persistent atrial fibrillation and its effect on cardiac structure. Methods: A total of 110 patients with persistent atrial fibrillation who were treated in our hospital from January 2023 to December 2023 were randomly selected and divided into observation group and control group by random number method, 55 patients in each group were treated with sacubactril valsartan + amiodarone or amiodarone alone. The proportion of electro cardioversion at 14 days after treatment, the recurrence rate at 1 year follow-up, the structural changes of left ventricle and left atrium before and after ultrasound, and the hemodynamic changes were compared between the two groups. Results: The 14 d electro cardioversion rate, 6-month and 1-year atrial fibrillation recurrence rates in the observation group were 20.00%, 10.91% and 27.27%, respectively, which were lower than those in the control group (49.49%, 25.45% and 58.18%, χ² = 10.292, P = 0.001; χ² = 3.911, P = 0.048; χ² = 10.736, P = 0.001). left anterior descending (LAD), left atrial volume (LAV), left atrial volume index (left atrial volume index), left anterior descending (LAD), left atrial volume index (LAV) LAVI), left atrial strain during reservoir phase (LASr), left ventricular ejection fraction (left ventricular ejection fraction, LASr) LVEF), left ventricular end diastolic diameter (left ventricular end diastolic diameter, There were no significant differences in LVEDD and left ventricular end systolic diameter (LVESD) levels (P > 0.05). After 1 year of treatment, there were intra-group differences in the above indicators between the two groups compared with before treatment (P < 0.05). However, LASr and LVEF in observation group were higher than those in control group, and other indexes were lower than those in control group (P < 0.05). There was no statistical difference in the heart rate between the two groups before treatment (P > 0.05), and the heart rate of the two groups after treatment was lower than that before treatment (P < 0.05), and the observation group was (75.44 ± 7.69) times/min, lower than the control group (88.63 ± 8.29) times/min, (t = 8.651; P < 0.001). Conclusion: Sakubactril valsartan is beneficial to the recovery of sinus rhythm in patients with persistent atrial fibrillation, and long-term use can help the recovery of heart structure and reduce heart rate, but does not affect the blood pressure of patients, which has good clinical application value.