Observation of the clinical efficacy of sacubitril-valsartan combined with Haikun Shenxi in the treatment of chronic left heart failure with renal insufficiency

Yili YUAN

ABSTRACT

Objective:To observe the clinical efficacy of sacubitril-valsartan combined with Haikun Shenxi in the treatment of chronic left heart failure with renal insufficiency.Methods:A total of 80 patients with chronic left heart failure and renal insufficiency who were admitted to Dalian Municipal Central Hospital from October 2019 to October 2020 were selected as the research objects. They were divided into two groups by random digits table method, 40 cases in each group. The control group was treated with sacubitril-valsartan. The observation group was based on the control group plus Haikun Shenxi Capsule, and N-terminal pro-brain natriuretic peptide (NT-proBNP), heart function indexes, kidney function indexes, blood gas indexes and quality of life in two groups were compared.Results:NT-proBNP, serum creatinine and blood urea nitrogen in the observation group were significantly lower than those in the control group after treatment: (1 034.27 ± 87.33) μg/L vs. (1 421.46 ± 105.54) μg/L, (240.53 ± 45.26) μmol/L vs. (284.52 ± 52.47) μmol/L, (12.05 ± 1.87) mmol/L vs. (15.79 ± 1.87) mmol/L, the difference was statistically significant ( t = 17.88, 4.01 and 8.62; P<0.01); left ventricular end-diastolic dimension (LVEDD) after treatment in the observation group was significantly lower than that in the control group: (46.12 ± 1.05) mm vs. (48.81 ± 1.74) mm, left ventricular ejection fraction (LVEF) and cardiac index (CI) were significantly higher than those in the control group: (49.95 ± 2.17)% vs. (45.24 ± 3.22)%, (2.98 ± 0.55) L/(min·m 2) vs. (2.45 ± 0.73) L/(min·m 2), the difference was statistically significant ( t = 7.67, 8.38 and 3.66; P<0.01); the blood gas index arterial partial pressure of carbon dioxide (PaCO 2) in the observation group after treatment was significantly lower than that in the control group: (46.34 ± 3.52) mmHg (1 mmHg = 0.133 kPa) vs. (51.63 ± 4.25) mmHg, arterial partial pressure of oxygen (PaO 2), oxygen saturation of haemoglobin (SO 2), pH, HCO 3-, base excess (BE) were significantly higher than the control group: (69.35 ± 5.12) mmHg vs. (62.45 ± 4.86) mmHg, (90.46 ± 4.02)% vs. (85.36 ± 4.32)%, 7.32 ± 0.12 vs. 7.22 ± 0.15, (23.1 ± 2.0) mmol/L vs. (21.5 ± 1.9) mmol/L, (-1.57 ± 0.67) mmol/L vs. (-2.15 ± 0.85) mmol/ L, the differences were statistically significant ( t = 6.06, 6.18, 5.47, 3.33, 3.67 and 3.39; P<0.01); the quality of life scores PD, ED, OD and TS in the observation group after treatment were lower than those in the control group: (17.80 ± 3.11) scores vs. (22.35 ± 2.72) scores, (12.28 ± 2.10) scores vs. (15.74 ± 1.73) scores, (18.27 ± 1.69) scores vs. (25.54 ± 2.33) scores, (46.68 ± 3.15) scores vs. (62.17 ± 3.63) scores, the differences was statistically significant ( t = 6.97, 8.05, 15.30 and 20.38; P<0.01). Conclusions:The sacubitril-valsartan combined with Haikun Shenxi in the treatment of chronic left heart failure with renal insufficiency has a significant clinical effect. It could effectively improve the patient's heart and kidney function and blood gas indicators, and further improve the patient's quality of life.