沙库巴曲缬沙坦对陈旧性前壁心肌梗死患者心功能的疗效评价  

Effect of sakubatril valsartan on heart function in patients with anterior old myocardial infarction

作　　者：田晋帆 宋现涛[1] 贺毅 张明多[1] 张东凤[1] 南楠[1] 杨雪瑶 雍婧雯 Tian Jinfan;Song Xiantao;He Yi;Zhang Mingduo;Zhang Dongfeng;Nan Nan;Yang Xueyao;Yong Jingwen(Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;不详)

机构地区：[1]北京市首都医科大学附属北京安贞医院心内科,北京100029 [2]北京市首都医科大学附属北京友谊医院放射科,北京100059

出　　处：《中国循证心血管医学杂志》2021年第3期289-292,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：国家然科学基金(81670324);首都卫生发展专项(2018-2-2063);2018年北京市优秀人才骨干(2018000021469G241);2020年北京市教育委员会科技计划项目(KM202010025016)。

摘　　要：目的评价沙库巴曲缬沙坦对陈旧性前壁心肌梗死患者心功能的疗效。方法以2019年3月至2020年3月于北京安贞医院心内科1A病房住院行冠状动脉(冠脉)造影的陈旧性前壁心肌梗死且接受沙库巴曲缬沙坦治疗的31例患者为研究对象。治疗后随访3~6个月。观察沙库巴曲缬沙坦对心功能指标:包括左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、血清B型脑钠肽(BNP)的影响;观察沙库巴曲缬沙坦对肝肾功能,包括血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、血尿素氮(BUN)、血清肌酐(Scr)水平的影响;观察沙库巴曲缬沙坦对患者1个月生活质量,患者健康问卷9(PHQ-9)和广泛性焦虑障碍量表-7(GAD-7)评分的影响。结果与治疗前相比,沙库巴曲缬沙坦治疗3~6个月后,陈旧性前壁心肌梗死患者LVEF显著增加[(51.1±13.1)vs.(37.9±8.6)%,P<0.01],LVEDD[(53.9±8.4)vs.(61.7±8.3)mm,P<0.05]及LVESD[(38.7±11.4)vs.(44.9±9.1)mm,P<0.05]显著降低。治疗前、后患者血清BNP、ALT、AST、Scr及BUN相比,差异均无统计学意义(P>0.05)。沙库巴曲缬沙坦治疗后,患者1个月的PHQ-9[(2.0±1.9)vs.(4.0±3.7),P<0.05]及GAD-7[(1.2±1.6)vs.(2.5±3.5),P<0.05]评分较治疗前均显著降低。结论沙库巴曲缬沙坦可明显改善陈旧性前壁心肌梗死心功能及生活质量,且不增加肝肾功能不良反应。Objective To review the effect of sakubatril valsartan on heart function in patients with anterior old myocardial infarction(OMI).Methods OMI patients(n=31)undergone coronary angiography(CAG)and treated with sakubatril valsartan were chosen from Department of Cardiology in Beijing Anzhen Hospital affiliated to Capital Medical University from Mar.2019 to Mar.2020.The patients were followed up for 3 months to 6 months after treatment.The influence of sakubatril valsartan on the indexes of heart function,including LVEF,LVEDD,LVESD and BNP were observed.The influence of sakubatril valsartan on the indexes of liver and kidney functions,including ALT,AST,BUN and Scr,were observed.The influence of sakubatril valsartan on scores of quality of life(QOL),Patient Health Questionnaire-9 Items(PHQ-9)and Generalized Anxiety Disorder-7 Items(GAD-7)were observed after treatment for 1 month.Results Compared with before treatment,LVEF increased significantly[(51.1±13.1)vs.(37.9±8.6)%,P<0.01],LVEDD decreased significantly[(53.9±8.4)vs.(61.7±8.3)mm,P<0.05]and LVESD decreased significantly[(38.7±11.4)vs.(44.9±9.1)mm,P<0.05]in OMI patients after treatment for 3-6 months.The difference in levels of serum BNP,ALT,AST,Scr and BUN had no statistical significance before and after treatment(P>0.05).After treatment,1-month PHQ-9[(2.0±1.9)vs.(4.0±3.7),P<0.05]and 1-month GAD-7[(1.2±1.6)vs.(2.5±3.5),P<0.05]decreased significantly in OMI patients.Conclusion Sakubatril valsartan can significantly improve heart function and QOL without increasing adverse reactions of liver and kidney in OMI patients.

关 键 词：陈旧性前壁心肌梗死 沙库巴曲缬沙坦 心功能 生活质量 

分 类 号：R542.22[医药卫生—心血管疾病]