沙库巴曲缬沙坦钠治疗瓣膜病心力衰竭的效果及对血清miRNA-21的影响

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摘要目的探讨沙库巴曲缬沙坦钠片治疗瓣膜病慢性心力衰竭的效果及对血清miRNA-21水平的影响。方法选取2018年3月至2021年5月粤北人民医院心血管内科门诊收治的84例瓣膜病心力衰竭患者作为研究对象，采用随机数字表法进行分组并实施双盲，将患者分为治疗组和对照组，每组各42例。两组患者均服用呋塞米、螺内酯、比索洛尔治疗，治疗组患者采用沙库巴曲缬沙坦钠，对照组患者采用替米沙坦，两组患者均治疗5个月。比较两组患者治疗前后的6 min步行距离和血清miRNA-21水平。结果治疗组患者治疗第2、3、4、5个月的6 min步行距离长于对照组，差异有统计学意义（P<0.001）；两组患者治疗第5个月的6 min步行距离长于治疗前，差异有统计学意义（P<0.001）。治疗组患者治疗第3、4、5个月的血清miRNA-21水平低于对照组，差异有统计学意义（P<0.001）；两组患者治疗第5个月的血清miRNA-21水平低于治疗前，差异有统计学意义（P<0.001）。结论沙库巴曲缬沙坦钠可显著提高瓣膜病心力衰竭患者的6 min步行距离，可能与下调miRNA-21的表达有关。

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	周启林
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关键词 ：沙库巴曲缬沙坦钠, 心脏瓣膜病, 慢性心力衰竭, miRNA-21

Abstract：Objective To investigate the therapeutic effect of Sacubitril Valsartan Sodium Tablet on chronic heart failure in patients with valvular disease and its effect on the level of serum miRNA-21. Methods A total of 84 patients with valvular disease and heart failure admitted to the Outpatient Department of Cardiovascular Medicine of Yuebei People′s Hospital from March 2018 to May 2021 were selected as the study subjects. The random number table method was used for grouping and double-blind, and patients were divided into treatment group and control group, with 42 patients in each group. Patients in both groups were treated with Furosemide, Spironolactone and Bisoprolol. Patients in the treatment group were treated with Sacubitril Valsartan Sodium and patients in the control group were treated with Telmisartan. Both groups were treated for 5 months. The 6-min walking distance and serum miRNA-21 level were compared between the two groups before and after treatment. Results The 6 min walking distance of the treatment group was longer than that of the control group at 2, 3, 4 and 5 months of treatment, and the difference was statistically significant (P<0.001). The 6-min walking distance of the two groups in the 5 month of treatment were longer than those before treatment, and the differences were statistically significant (P<0.001). The serum miRNA-21 level in treatment group was lower than that in control group at 3, 4 and 5 months of treatment, the difference was statistically significant (P<0.001). The serum miRNA-21 levels in the two groups at 5 months of treatment were lower than those before treatment, the differences were statistically significant (P<0.001). Conclusion Sacubitril Valsartan Sodium has a significant effect on the prolongation of 6 min walking distance in patients with cardiac valvular heart failure, and this effect may be related to the down regulation of miRNA-21 expression.

Key words： Sacubitril Valsartan Sodium Cardiac valvular heart disease Chronic heart failure MiRNA-21

基金资助:广东省韶关市卫生健康科研项目（Y20217）；
广东省韶关市科技计划项目（200812114531457）。

作者简介: 周启林（1978-），男，硕士，副主任医师，副教授，研究方向：心力衰竭。

引用本文:

周启林；黄波；周婉明；马占忠；汪丽. 沙库巴曲缬沙坦钠治疗瓣膜病心力衰竭的效果及对血清miRNA-21的影响[J]. 中国当代医药, 2022, 29(19): 61-64转69.
ZHOU Qilin ； HUANG Bo ； ZHOU Wanming ； MA Zhanzhong； WANG Li. Efficacy of Salkubazol Valsartan Sodium in the treatment of heart failure in patients with valvular disease and its effect on serum miRNA-21. 中国当代医药, 2022, 29(19): 61-64转69.

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[1]	Groenewegen A，Rutten FH，Mosterd A，et al.Epidemiology of heart failure[J].Eur J Heart Fail，2020，22（8）：1342-1356.
[2]	中国心血管健康与疾病报告编写组.中国心血管健康与疾病报告2019概要[J].中国循环杂志，2020，35（9）：833-854.
[3]	邱伯雍，王永霞.慢性心力衰竭流行病学及防治研究进展[J].中华实用诊断与治疗杂志，2017，31（6）：619-621.
[4]	Sokos GG，Raina A.Understanding the early mortality benefit observed in the PARADIGM-HF trial：consideration for the management of heart failure with sacubitril/valsartan[J].Vasc Health Risk Manag，2020，16：41-51.
[5]	Solomon SD，Vaduganathan M，L Claggett B，et al.Sacubitril/Valsartan Across the Spectrum of Ejection Fraction in Heart Failure[J].Circulation，2020，141（5）：352-361.
[6]	Yancy CW，Jessup M，Bozkurt B，et al.2016ACC/AHA/HFSA Focused Update on New Pharmacological Therapy for Heart Failure：An update of 2013 ACC/AHA Guideline for the Management of Heart Failure[J].J Am coll Cardiol，2016， 68（13）：1476-1488.
[7]	中华医学会心血管病分会心力衰竭学组.中国心力衰竭诊断和治疗指南2018[J].中华心血管病杂志，2018，46（10）：760-789.
[8]	Huang YM，Li WW，Wu J，et al.The diagnostic value of circulating microRNAs in heart failure[J].Exp Ther Med，2019， 17（3）：1985-2003.
[9]	谭顺林.血清miRNA-21.miR126异常表达对慢性心力衰竭患者的临床意义[J].国际检验医学杂志，2017，38（13）：1844-1846.
[10]	Nishimura RA，Otto CM，Bonow RO，et al.2014 AHA/ACC guideline for the management of patients with valvular heart disease：a report of the American College of Cardiology/American Heart Association task force on practice guidelines[J].J Am Coll Cardiol，2014，63（22）：e57-185.
[11]	中华医学会超声医学分会超声心动图学组.中国成年人超声心动图检查测量指南[J].中华超声影像学杂志，2016， 25（8）：645-662.
[12]	杨力凡，周达新.老年退行性心脏瓣膜病发病机制的研究进展[J].中华心血管病杂志，2017，45（10）：895-898.
[13]	齐喜玲，许海燕，刘庆荣，等.中国老年退行性心脏瓣膜病住院患者诊疗现状分析[J].中国循环杂志，2019，34（8）：771-776.
[14]	马丽媛，吴亚哲，王文，等.《中国心血管病报告2017》要点解读[J].中国心血管杂志，2018，23（1）：3-6.
[15]	李倩，吴海波，刘佳，等.沙库巴曲缬沙坦在心肾功能不全患者中的应用进展[J].中国医药科学，2021，11（9）：40-43.
[16]	Wang YW，Zhou R，Lu C，et al.Effects of the angiotensin-receptor neprilysin inhibitor on cardiac reverse remodeling：meta-analysis[J].J Am Heart Assoc，2019，8（13）：e012272.
[17]	努热曼古丽·阿布都克热木，宋博凡，冯俊.沙库巴曲缬沙坦在心力衰竭治疗中的研究进展[J].中国医药科学，2021，11（19）：54-58.
[18]	刘俏贤，钟伟章，韦广，等.沙库巴曲缬沙坦治疗慢性心力衰竭患者的临床效果及对心功能的影响[J].中国当代医药，2021，28（23）：184-186，190.
[19]	李崇耀，张曼，赵鸿斌，等.沙库巴曲缬沙坦联合芪苈强心胶囊治疗慢性心力衰竭患者的临床疗效观察[J].疑难病杂志，2020，19（7）：667-671.
[20]	Dong S，Ma W，Hao B，et al.MicroRNA-21 promotes cardiac fibrosis and development of heart failure with preserved left ventricular ejection fraction by up-regulating Bcl-2[J].Int J Clin Exp Pathol，2014，7（2）：565-574.
[21]	Verjans R，Peters T，Beaumont FJ，et al.MicroRNA-221/222 family counteracts myocardial fibrosis in pressure overload-induced heart failure[J].Hypertension，2018，71（2）：280-288.
[22]	周丽华，杨威，吉中蛟.老年慢性心力衰竭患者血清MR-ProADM、miRNA-21水平变化与预后的关系研究[J].中国免疫学杂志，2019，35（23）：2904-2910.
[23]	宋秉春，张金国.心肌纤维化发病机制及治疗进展[J].济宁医学院学报，2015，38（1）：65-67，70.
[24]	Thum T，Gross C，Fiedler J.et al.MicroRNA-21 contributes to myocardial disease by stimulating MAP Kinase signalling in fibroblasts[J].Nature，2008，456（7224）：980-984.
[25]	Huang CK，B■r C，Thum T.miR-21，mediator，and potential therapeutic target in the cardiorenal syndrome[J].Front.Pharmacol，2020，11：726