诺欣妥用于STEMI冠脉介入术后HFrEF患者的临床观察  

Clinical Observation of Sacubitril Valsartan Sodiumfor HFrEF Patients after STEMI Percutaneous Coronary Intervention

作　　者：付宁宁 徐兆龙 Fu Ningning;Xu Zhaolong(The First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000 China)

机构地区：[1]锦州医科大学附属第一医院心内科,辽宁锦州121000

出　　处：《锦州医科大学学报》2022年第2期93-97,共5页Journal of Jinzhou Medical University

摘　　要：目的比较诺欣妥(沙库巴曲缬沙坦钠)与福辛普利钠治疗急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)初次经皮冠脉介入治疗术(percutaneous coronary intervention,PCI)后并射血分数减低型心力衰竭(ejection fraction reduced heart failure,EFrHF)患者的疗效和安全性。方法选STEMI行急诊PCI术后出现HFrEF的住院患者126例,随机分为观察组(n=63)和对照组(n=63),均在给予心力衰竭的常规治疗基础上,观察组给予诺欣妥,对照组给予福辛普利钠,用药治疗6个月后与用药前对照分析两组疗效:(1)左心室射血分数(left ventricular ejection fraction,LVEF)、NT-proBNP;(2)左心房内径(left atrium dimension,LAd)、左室舒张末期容积(left ventricular end diastolic dimension,LVEDD)、左室收缩末期容积(left ventricular end-systolic dimension,LVESD);(3)堪萨斯城心衰生活质量调查问卷(The Kansas city cardiomyopathy questionnaire,KCCQ)评分。不良反应:(1)心血管事件(心源性死亡、再发心肌梗死、因心衰再入院);(2)一般不良反应(高钾血症、肾功能不全、血管性神经性水肿、症状性低血压)。结果两组药物治疗6个月后较用药前:(1)LVEF、NT-proBNP、LAd、LVEDD、LVESD和KCCQ评分均明显改善(P<0.05),且观察组优于对照组(P<0.05);(2)不良反应:观察组MACE发生率(19.05%)较对照组(36.51%)少,差异有统计学意义(P<0.05);(3)一般不良反应无统计学意义(P>0.05)。结论诺欣妥与福辛普利钠相比,对STEMI PCI术后并HFrEF的患者疗效更好且用药安全。Objective To compare the efficacy and safety of sacubitril valsartan sodium and fosinopril sodium in the treatment of patients with acute ST-segment elevation myocardial infarction(STEMI)after primary percutaneous coronary intervention(PCI)with reduced ejection fraction heart failure(HFrEF).Methods 126 hospitalized patients with HFrEF after STEMI emergency PCI were randomly divided into the observation group(n=63)and the control group(n=63).On the basis of routine treatment of heart failure,observation group was given sacubitril valsartan sodium,while control group was given fosinopril sodium.After 6 months of treatment,the efficacy of the two groups were compared with that before treatment:(1)Left ventricular ejection fraction(LVEF)and NT-proBNP;(2)Left atrial diameter(LAd),left end diastolic volume(LVEDV)and left ventricular end systolic volume(LVESV);(3)the kansas city cardiomyopathy questionnaire(KCCQ);adverse reactions:(1)Cardiovascular events(cardiac death,recurrent myocardial infarction,readmission due to heart failure);(2)general adverse reactions(hyperkalemia,renal insufficiency,vascular neuroedema,symptomatic hypotension).Results After 6 months of treatment:(1)LVEF,NT-proBNP,LAd,LVEDD,LVESD and KCCQ scores of the two groups were significantly improved(P<0.05),and the observation group was superior to the control group(P<0.05);(2)side effects:The incidence of MACE events in the observation group(19.05%)was significantly lower than that in the control group(36.51%),and the difference was statistically significant(P<0.05);(3)general adverse reactions were not statistically significant(P>0.05).Conclusion Compared with Fosinopril Sodium,sacubitril valsartan sodium has better clinical efficacy and safety in patients with STEMI PCI and HFrEF.

关 键 词：诺欣妥 福辛普利钠 急性心肌梗死 心力衰竭 

分 类 号：R541[医药卫生—心血管疾病]