老年缺血性心肌病导致射血分数降低心力衰竭患者使用沙库巴曲缬沙坦后随访1年的不良心血管事件研究  

A 1-year Follow-up Study of Adverse Cardiovascular Events in Elderly Patients with Heart Failure with Reduced Ejection Fraction due to Ischemic Cardiomyopathy Using Sacubitril-valsartan

作　　者：张会珍[1] 肖冬[2] 张艳玲[1] ZHANG Huizhen;XIAO Dong;ZHANG Yanling(Department of Cardiology,Jinan First People´s Hospital,Jinan,Shandong Province,250000 China;Department of Internal Medicine,Jinan Hospital,Jinan,Shandong Province,250000 China)

机构地区：[1]济南市第一人民医院心内科,山东济南250000 [2]济南医院内科,山东济南250000

出　　处：《中外医疗》2022年第28期57-60,69,共5页China & Foreign Medical Treatment

摘　　要：目的探究老年缺血性心肌病导致射血分数降低心力衰竭(heart failure with reduced ejection fraction,HFrEF)患者使用沙库巴曲缬沙坦治疗后随访1年的主要不良心血管事件(major adverse cardiovascular events,MACE)。方法回顾性分析2018年6月—2020年6月于济南市第一人民医院接受治疗的90例老年缺血性心肌病导致HFrEF患者,其中45例接受常规抗心力衰竭治疗纳入常规组;另45例接受沙库巴曲缬沙坦治疗纳入治疗组。观察两组MACE发生率,用药前(首次就诊时)、用药后(治疗随访1年后)心功能指标、血清学指标的差异。结果治疗组MACE总发生率为35.56%,低于常规组80.00%,差异有统计学意义(χ^(2)=18.219,P<0.05);用药后,治疗组左心室后壁厚度、左心室舒张末期内径与常规组比较,差异无统计学意义(P>0.05),但左室射血分数高于用药前,且高于同时期的常规组,差异有统计学意义(P<0.05);用药后,治疗组血清N末端B型利钠肽前体水平低于用药前,且低于同时期的常规组,差异有统计学意义(P<0.05)。结论沙库巴曲缬沙坦有利于改善老年缺血性心肌病导致HFrEF患者的心功能,并降低随访1年MACE的发生率,取得较好的疗效及预后。Objective To investigate the 1-year follow-up of major adverse cardiovascular events(MACE)in elderly patients with ischemic cardiomyopathy-induced heart failure with reduced ejection fraction(HFrEF)treated with sacubitril-valsartan.Methods A retrospective analysis was performed on 90 elderly patients with HFrEF caused by ischemic cardiomyopathy who received treatment in the First People’s Hospital of Jinan from June 2018 to June 2020.Among them,45 patients received conventional anti-heart failure treatment and were included in the conventional group.Another 45 patients received sacubitril and valsartan and were included in the treatment group.The incidence of MACE,the differences in cardiac function indexes and serological indexes before medication(at the first visit)and after medication(after 1 year of follow-up after treatment)were observed between the two groups.Results The total incidence of MACE in the treatment group was 35.56%,which was lower than that in the routine group(80.00%),the difference was statistically significant(χ^(2)=18.219,P<0.05).After treatment,there was no statistically significant difference between the treatment group and the conventional group in left ventricular wall thickness and left ventricular enddiastolic diameter(P>0.05),but the left ventricular ejection fraction was higher than before treatment and higher than that in the conventional group at the same time period,the difference was statistically significant(P<0.05).After treatment,the serum N-terminal B-type natriuretic peptide precursor level in the treatment group was lower than before treatment,and lower than that in the routine group at the same period,the difference was statistically significant(P<0.05).Conclusion Sacubitril-valsartan is beneficial to improve the cardiac function of elderly patients with HFrEF caused by ischemic cardiomyopathy,and reduce the incidence of MACE during 1-year follow-up,and achieve better curative effect and prognosis.

关 键 词：缺血性心肌病 射血分数降低 心力衰竭 沙库巴曲缬沙坦 

分 类 号：R4[医药卫生—临床医学]