沙库巴曲缬沙坦对AAMI合并急性心功能不全患者的近期效果及心肌重构的影响  

Influence of sakubatril-valsartan on short-term effect and myocardial remodeling in patients with acute anterior myocardial infarction complicated by acute cardiac insufficiency

作　　者：岳锦明 王维箭[1] 韦平 覃剑斌 Yue Jinming;Wang Weijian;Wei Ping;Qin Jianbin(Department of Cardiovascular Medicine,Red Cross Hospital of Wuhou City,Wuzhou 543002,China.;不详)

机构地区：[1]梧州市红十字会医院心血管内科,梧州543002

出　　处：《中国循证心血管医学杂志》2023年第2期230-233,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探究沙库巴曲缬沙坦对急性前壁心肌梗死(AAMI)合并急性心功能不全患者的近期效果及心肌重构的影响。方法选取2019年1月至2022年1月于梧州市红十字会医院心血管内科确诊为AAMI合并急性心功能不全的108例患者为研究对象,按照随机1:1分组分为观察组和对照组,每组各54例。评估两组患者临床近期疗效;超声检测左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)、左室射血分数(LVEF);采用电化学全自动免疫分析仪检测血清肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)、N末端脑钠肽前体(NT-proBNP)水平;记录患者心血管不良事件(MACEs)和不良反应发生情况。结果治疗后,观察组总有效率为96.30%,高于对照组的总有效率88.89%,差异无统计学意义(P>0.05)。治疗3个月后,观察组LVEF高于对照组,LVESD、LVEDD、LVESV和LVEDV均低于对照组,差异有统计学意义(P<0.05)。观察组NT-proBNP低于对照组(P<0.05)。观察组MACEs发生率为16.67%,不良反应发生率为12.96%,分别低于对照组的31.48%和25.93%,差异无统计学意义(P>0.05)。结论沙库巴曲缬沙坦对于AAMI合并急性心功能不全的疗效确切,可有效抗心肌重构,其MACEs和不良反应发生率较低。Objective To investigate the influence of of sakubatril-valsartan on short-term effect and myocardial remodeling in patients with acute anterior myocardial infarction(AAMI)complicated by acute cardiac insufficiency.Methods The patients diagnosed with AAMI complicated by acute cardiac insufficiency(n=108)were chosen from Department of Cardiovascular Medicine in Red Cross Hospital of Wuhou City from Jan.2019 to Jan.2022,and all patients were randomly,in a ratio of 1:1,divided into observation group and control group(each n=54).The short-term curative effect was reviewed in 2 groups.The indexes of left ventricular end-diastolic inner diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV)and left ventricular ejection fraction(LVEF)were detected by using ultrasonography.The levels of creatine kinase-MB isoenzyme(CK-MB),cardiac troponin I(cTnI)and N-terminal pro-brain natriuretic peptide(NT-proBNP)were detected by using electrochemical full-automatic immunoassay analyzer.The occurrence of major adverse cardiovascular events(MACE)and adverse reactions were recorded.Results After treatment,the total effective rate in observation group(96.30%)was higher than that in control group(88.89%,P>0.05).After treatment for 3 months,LVEF was higher,and LVESD,LVEDD,LVESV and LVEDV were lower in observation group than those in control group(P<0.05).NT-proBNP was lower in observation group than that in control group(P<0.05).The incidence rate of MACE was 16.67%in observation group and 31.48%in control group,and and incidence rates of adverse reactions were 12.96%in observation group and 25.93%in control group(P>0.05).Conclusion Sakubatril-valsartan has definite curative effect on AAMI complicated by acute cardiac insufficiency,and can resist myocardial remodeling and reduce incidence rates of MACE and adverse reactions.

关 键 词：急性前壁心肌梗死 沙库巴曲缬沙坦 急性心功能不全 心肌重构 

分 类 号：R542.22[医药卫生—心血管疾病]