沙库巴曲缬沙坦钠对急性心肌梗死泵衰竭患者疗效及心功能、心室重构指标的影响  

Effect of Sacubatril Valsartan Sodium on the Efficacy,Cardiac Function and Ventricular Remodeling Indexes in Patients with Acute Myocardial Infarction Pump Failure

作　　者：黄丽娟 曾玉玲 占德进 林施峰 HUANG Li-juan;ZENG Yu-ling;ZHAN De-jin;LIN Shi-feng(Affiliated Ningde Hospital of Fujian Medical University,Ningde 352000,China)

机构地区：[1]福建医科大学附属宁德市医院,宁德352000

出　　处：《微循环学杂志》2020年第3期36-40,共5页Chinese Journal of Microcirculation

基　　金：福建省宁德市科学技术计划项目(20160035)。

摘　　要：目的:观察沙库巴曲缬沙坦钠治疗急性心肌梗死后泵功能衰竭的疗效,分析该药物对患者心功能、心室重构指标的影响。方法:选择2017-12—2019-12在本院住院的急性心肌梗死后泵功能衰竭患者160例,按就诊顺序编号,单号进入研究组,双号进入对照组,两组均为80例。对照组采用常规抗心衰药物治疗,研究组在此基础上加用沙库巴曲缬沙坦钠(口服,目标剂量400mg/天),连续4周(1个疗程)。比较两组临床疗效,检测分析两组患者治疗前后血压、心率、尿量,心功能指标左室收缩末期内径(LVEDS)、左室舒张末期内径(LVEDd)、左室内径缩短率(FS)、左室射血分数(LVEF)及心室重构相关指标室间隔厚度(IVST)、左室质量(LNMI)等的变化。比较两组患者治疗期间不良反应发生率及治疗后随访6个月再住院率与死亡率。结果:研究组治疗总有效率高于对照组(P<0.05)。两组治疗后与本组治疗前比较,收缩压、舒张压升高,心率降低,尿量增加(均P<0.01);研究组治疗后上述指标较对照组治疗后改善更好(P<0.01)。治疗后,两组患者LVEDs、LVEDd、IVST、LVMI水平均较本组治疗前降低,LVEF、FS水平均较本组治疗前升高(P<0.01);研究组治疗后上述指标较对照组治疗后变化更积极(P<0.01)。组间不良反应发生率、死亡率无明显差异(P>0.05)。研究组再住院率低于对照组(P<0.05)。结论:沙库巴曲缬沙坦钠辅助治疗急性心肌梗死后泵功能衰竭,可提高疗效,改善患者心功能和左室重构,减少再住院率。Objective:To observe the curative effect of sacubatril valsartan sodium in the treatment of pump failure after acute myocardial infarction,and to analyze the effect of this drug on patients'cardiac function and ventricular remodeling.Method:160 patients with acute myocardial infarction and pump failure who were hospitalized in our hospital from December 2017 to December 2019 were numbered according to the order of visits,the odd number entered the study group,and the even number entered the control group.Each group had 80 cases.The control group received conventional and traditional anti-heart failure drug treatment,and the study group added valsartan sodium(oral,target dose 400mg/d).They were treated continuously for 4 weeks(1 course).The clinical efficacy of the two groups was,and contaced the blood pressure,heart rate,urine output,left ventricular end systolic diameter(LVEDS),left ventricular end diastolic diameter(LVEDd),left ventricular fraction shortening(FS),left ventricular ejection fraction(LVEF),and the changes on levels of ventricular remodeling-related indexes:interventricular septal thickness(IVST),left ventricular mass index(LNMI)etc were detected before and after treatment.The incidence of adverse reactions during treatment and the re-hospitalization rate and mortality rate after treatment for 6 months of follow-up were compared between the two groups.Results:The total effective rate of treatment in the study group was higher than that in the control group(P<0.05).Compared after treatment with before treatment between the two groups,the systolic blood pressure and diastolic blood pressure were increased,heart rate was decreased,and urine output was increased(P<0.01).The treatment in the study group improved more than the control group after treatment(P<0.01).After treatment,the levels of LVEDs,LVEDd,IVST,and LVMI of the two groups were lower than that of this group before treatment,and the levels of LVEF and FS were higher than that of this group before treatment(P<0.01).After treatment in the stud

关 键 词：急性心肌梗死 泵功能衰竭 沙库巴曲缬沙坦钠 疗效 心功能 心室重构 

分 类 号：R541[医药卫生—心血管疾病]