沙库巴曲缬沙坦对行急诊PCI术的急性前壁心肌梗死病人左心室重塑指标及心功能的影响  

The effect of Sacubitril/Trivalsartan on left ventricular remodeling and cardiac function in patients with acute anterior myocardial infarction after emergency PCI

作　　者：侯琳琳 冯俊[1] HOU Lin-lin;FENG Jun(Department of Cardiology,Hefei Second People′s Hospital,Hefei Anhui 230000,China)

机构地区：[1]安徽省合肥市第二人民医院心血管内科,230000

出　　处：《蚌埠医学院学报》2023年第4期493-497,共5页Journal of Bengbu Medical College

基　　金：安徽省合肥市卫生健康应用医学研究项目;蚌埠医学院自然科学基金(2020byzd325)。

摘　　要：目的:探讨沙库巴曲缬沙坦对行急诊经皮冠状动脉介入治疗(PCI)后的急性前壁心肌梗死病人左心室重塑指标及心功能的影响。方法:选取住院的急性前壁心肌梗死病人60例,按随机数字表法分为观察组(30例)和对照组(30例)。2组病人均急诊行PCI,术后在一般治疗的基础上,分别使用沙库巴曲缬沙坦和贝那普利,治疗12个月。2组病人在出院前1 d,出院后1、3、6、12个月分别记录左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、室间隔厚度(IVST)、左心室质量指数(LVMI),同时记录病人的氨基末端脑钠肽前体(NT-proBNP)、生活质量量表(KCCQ)评分、6 min步行实验(6MWT)、心脑血管不良事件及药物不良反应。结果:观察组LVEDD在出院后1、3、6、12个月较对照组降低(P<0.05~P<0.01);观察组LVEF在出院后1、3、6、12个月均较出院前1 d升高(P<0.05),对照组LVEF在出院后6、12个月亦较出院前1 d增加(P<0.05),观察组LVMI在出院后3、6、12个月较对照组降低(P<0.05)。随着治疗时间的延长,2组病人NT-proBNP逐渐下降(P<0.05),且观察组在出院后1、3个月较对照组下降(P<0.05和P<0.01);2组病人KCCQ在出院后3、6、12个月较出院前1 d升高(P<0.05),2组病人6MWT在出院后1、3、6、12个月与出院前1 d比较明显增加(P<0.05)。2组病人主要心脑血管不良事件和药物不良反应总发生率比较差异无统计学意义(P>0.05)。结论:沙库巴曲缬沙坦和贝那普利治疗急诊行PCI术后的急性前壁心肌梗死病人,都能够很好地延缓心室重塑及改善心功能,且安全性相当,但对于延缓左心室重塑程度及心功能改善速度方面,沙库巴曲缬沙坦优于贝那普利。Objective:Objective to investigate the effect of Sacubitril/trivalsartan on left ventricular remodeling and cardiac function in patients with acute anterior myocardial infarction after emergency percutaneous coronary intervention(PCI).Methods:Sixty inpatients with acute anterior myocardial infarction of Hefei Second People′s Hospital from January 2019 to December 2019 were selected as the research objects.The patients were randomly divided into experimental group(n=30)and control group(n=30).Both groups were treated with emergency PCI.Besides the conventional treatment,for 12 months,Sacubitril/trivalsartan and benazepril were given to the patients in experimental and control group respectively.The follow-up was done at the day before discharge and at 1,3,6 and 12 months after discharge.Left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),interventricular septal thickness(IVST)and left ventricular mass index(LVMI)were recorded.At the same time,NT-proBNP,KCCQ,6MWT,cardiovascular adverse events and adverse drug reactions were recorded.Results:LVEDD in the observation group was lower than that in the control group at 1,3,6,12 months after discharge(P<0.05 to P<0.01);LVEF in the observation group increased 1,3,6 and 12 months after discharge compared with the day before discharge(P<0.05),LVEF in the control group increased 6 and 12 months after discharge compared with the day before discharge(P<0.05),LVMI in the observation group decreased 3,6 and 12 months after discharge compared with the control group(P<0.05).With the prolongation of treatment time,NT proBNP of patients in the two groups decreased gradually(P<0.05),and the observation group decreased significantly at 1 and 3 months after discharge when compared with the control group(P<0.05 and P<0.01);KCCQ of patients in the two groups increased at 3,6,12 months after discharge compared with the day before discharge(P<0.05),and 6MWT of patients in the two groups increased significantly at 1,3,6,12 months after discharge compare

关 键 词：心肌梗死 经皮冠状动脉介入治疗 沙库巴曲缬沙坦 心室重塑 心功能 

分 类 号：R542.22[医药卫生—心血管疾病]