诺欣妥治疗急性心梗合并心力衰竭患者的效果及康复情况分析  

Analysis of the effect and rehabilitation of Nuoxinto in the treatment of patients with acute myocardial infarction and heart failure

作　　者：陈乔[1] 胡艳辉 黄俐 冯熙 李雪玉 CHEN Qiao;HU Yanhui;HUANG Li;FENG Xi;LI Xueyu(Cardiovascular Clinical Medical Center, Liyuan Hospital Affiliated to Tongji Medical College of Huazhong University of Science And Technology, Wuhan 430077, China)

机构地区：[1]华中科技大学同济医学院附属梨园医院心血管临床医学中心,湖北武汉430077

出　　处：《西部医学》2022年第3期386-390,395,共6页Medical Journal of West China

基　　金：湖北省卫生健康管理委员会科研项目(WJ2019Q037)。

摘　　要：目的探讨急性心梗(AMI)合并心力衰竭(HF)患者应用诺欣妥后的康复情况以及左心室功能、结构的变化。方法选取2018年4月~2019年12月我院收治的96例AMI合并HF患者为研究对象。根据治疗方式不同分为诺欣妥组(n=52)和血管紧张素转化酶抑制剂组(ACEI组,n=44)。诺欣妥组给予诺欣妥治疗,ACEI组给予常规ACEI治疗。比较两组患者的疗效、不良反应发生率、心功能[左室收缩末期内径(LVEDs)、左室舒张末期内径(LVEDd)以及左室射血分数(LVEF)]、室间隔厚度(IVST)、左室质量指数(LVMI)及血清炎症因子[氨基末端脑钠肽前体(NT-proBNP)、白介素-6(IL-6)、白介素-(IL-8)与肿瘤坏死因子α(TNF-α)],并进行一年预后随访,比较两组患者预后情况。结果诺欣妥组治疗总有效率高于ACEI组(P<0.05),两组不良反应发生率比较差异无统计学意义(P>0.05)。治疗后,两组LVEDs、LVEDd、IVST、LVMI以及炎症因子NT-proBNP、IL-6、IL-8、TNF-α均低于治疗前,且诺欣妥组低于ACEI组,而LVEF高于治疗前,且诺欣妥组高于ACEI组(均P<0.05)。预后随访显示,两组预后存活情况无统计学差异(P>0.05),而MLHFQ评分中,诺欣妥组身体活动、情感状态及其他情况均优于ACEI组,疾病复发率低于ACEI组(P<0.05)。结论诺欣妥治疗急性心梗合并心力衰竭的效果显著且具有较高的安全性,可有效改善患者的左心室功能与结构,抑制炎性反应的发生,提升预后生活质量并降低复发率,具有较高的临床应用价值。Objective To explore the rehabilitation of patients with acute myocardial infarction(AMI)combined with heart failure(HF)after applying Nucinto and the changes in left ventricular function and structure.Methods From April 2018 to December 2019,52 patients with AMI and HF in our hospital were selected and received Nuoxinto treatment and regarded as the Nuoxinto group.Another 44 patients received conventional ACEI treatment and regarded as the ACEI group.The efficacy,incidence of adverse reactions,heart function,inflammatory factors of the two groups of patients were compared between the two groups,and the prognosis of the two groups were followed up for one year to compare the prognosis of the two groups.Results The total effective rate of Nuoxinto group(92.31%)was higher than that of ACEI group(P<0.05).There was no difference in the incidence of adverse reactions(P>0.05).After treatment,LVEDs,LVEDd,IVST,LVMI and inflammatory factors in Xintuo group were lower than that in ACEI group,while LVEF in Xintuo group was higher than that in ACEI group(P<0.05).Prognostic follow-up showed that there was no statistical difference in prognostic survival between the two groups(P>0.05).In the MLHFQ score,the physical activity,emotional state,and other conditions of the Nuoxinto group were better than those of the ACEI group,and the disease recurrence rate was lower than that of the ACEI group(P<0.05).Conclusion Nuoxinto has a significant effect in the treatment of AMI with HF and has high safety.It can effectively improve the left ventricular function and structure of patients,inhibit the occurrence of inflammatory reactions,improve the prognostic quality of life and reduce the recurrence rate.

关 键 词：急性心梗合并心力衰竭 诺欣妥 左心室功能 左心室结构 炎症因子 预后生活质量 

分 类 号：R542.22[医药卫生—心血管疾病] R541.6[医药卫生—内科学]