沙库巴曲缬沙坦联合运动康复对经皮冠状动脉介入治疗术后心力衰竭患者的影响  

Effects of sacubitril valsartan combined with exercise rehabilitation on heart failure patients following PPCI surgery

作　　者：梁爱诗 罗君婷 刘明[1] 赵艳梅[1] Liang Aishi;Luo Junting;Liu Ming;Zhao Yanmei(Department of Cardiovascular Medicine,First People's Hospital of Yulin,Yulin,Guangxi Zhuang Autonomous Region 537000,China)

机构地区：[1]玉林市第一人民医院心血管内科,广西壮族自治区玉林537000

出　　处：《中国药物与临床》2025年第7期434-439,共6页Chinese Remedies & Clinics

基　　金：广西科技计划项目(AA22096030);玉林市科学研究与技术开发计划项目(20220634);玉林市科学研究与技术开发计划项目(20204031)。

摘　　要：目的探讨沙库巴曲缬沙坦联合运动康复对急性心肌梗死经皮冠状动脉介入治疗(PPCI)术后合并心力衰竭患者的影响。方法选择2021年9月至2023年12月玉林市第一人民医院急性心肌梗死PPCI术后合并心力衰竭的患者52例,采用随机数字表法分为2组,试验组28例,对照组24例,2组患者都接受最优化药物常规治疗,并且2组都同步使用相同药物及剂量。对照组在此基础上给予沙库巴曲缬沙坦钠片治疗。试验组在对照组的基础上联合院内早期心脏运动康复治疗。观察2组患者出院3个月的心功能指标包括左心室收缩期射血分数(LVEF)、左心室舒张末期内径(LVED)、左心房内径(LAD)、肌红蛋白(Myo)、肌钙蛋白T(cTnT)、肌酸激酶同工酶(CK-MB)、氨基末端B型利钠肽前体(NT-ProBNP)、无氧阈摄氧量(VO_(2)AT)、峰值摄氧量(VO_(2)peak)、峰值代谢当量(Mets)等,并观察2组合并症的发生。结果试验组患者的LVEF、VO_(2)AT、VO_(2)peak、峰值Mets均较对照组升高(P<0.05),LVED、NT-proBNP均较对照组减小(P<0.05),而Myo、cTnT、CK-MB、LAD与对照组相比,差异无统计学意义(P>0.05)。结论沙库巴曲缬沙坦联合心脏运动康复能抑制急性心肌梗死PPCI术后合并心力衰竭患者的心室重构,提高患者运动耐力,改善患者心功能。Objective To investigate the effects of sacubitril valsartan combined with exercise rehabilita tion on heart failure patients following primary percutaneous coronary intervention(PPCI)for acute myocardial in farction.Methods A total of 52 patients with heart failure after PPCI for acute myocardial infarction at First Peo ple′s Hospital of Yulin from September 2021 to December 2023 were enrolled and divided into an experimenta group(28 cases)and a control group(24 cases)by random number table method.Both groups received optima conventional medical therapy with identical medications and dosages.The control group was additionally treated with sacubitril valsartan tablets,while the experimental group received sacubitril valsartan combined with early in hospital cardiac exercise rehabilitation.Cardiac function parameters were assessed at 3 months post-discharge,in cluding left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVED),left atrial diamete(LAD),myoglobin(Myo),cardiac troponin T(cTnT),creatine kinase-MB(CK-MB),N-terminal pro-B-type natriuret ic peptide(NT-proBNP),anaerobic threshold oxygen uptake(VO_2AT),peak oxygen uptake(VO_2peak)and peak metabolic equivalents(Mets).The incidence of comorbidities was also recorded and compared between the two groups.Results Compared to the control group,the experimental group exhibited significantly increased left ven tricular ejection fraction(LVEF),anaerobic threshold oxygen uptake(VO_2AT),peak oxygen uptake(VO_2peak)and peak metabolic equivalents(Mets)levels(P<0.05),along with significantly reduced left ventricular enddiastolic diameter(LVED)and N-terminal pro-B-type natriuretic peptide(NT-proBNP)levels(P<0.05).No statistically sig nifi-cant differences were observed in myoglobin(Myo),cardiac troponin T(cTnT),creatine kinase-MB(CK-MB)or left atrial diameter(LAD)between the two groups(P>0.05).Conclusion The combination of sacubitril valsar tan and cardiac exercise rehabilitation effectively inhibits ventricular remodeling,enhances exercise to

关 键 词：沙库巴曲缬沙坦 运动康复 心肌梗死 经皮冠状动脉介入治疗 心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]