沙库巴曲缬沙坦联合比伐芦定对冠心病PCI术后患者的影响  

Fffect of sacubitril/valsartan combined with bivalirudin on patients with coronary heart disease after percutaneous coronary intervention

作　　者：路俊生 李朋 孙旭玲 LU Junsheng;LI Peng;SUN Xuling(Department of Cardiology,Rizhao Downtown Hospital,Rizhao 276800,China)

机构地区：[1]日照市中心医院心内科,山东日照276800

出　　处：《中国处方药》2025年第7期6-9,共4页Journal of China Prescription Drug

摘　　要：目的探讨沙库巴曲缬沙坦联合比伐芦定对冠心病经皮冠状动脉介入(PCI)术后患者的影响。方法选定2020年3月~2023年10月收治的138例PCI术后患者,采用随机信封法将其分为对照组(n=69)和治疗组(n=69)。对照组选用常规用药(阿司匹林肠溶片、酒石酸美托洛尔片、阿托伐他汀钙片)进行治疗,治疗组采用沙库巴曲缬沙坦联合比伐芦定治疗。检测并比较两组治疗临床疗效、心功能指标[左室舒张末期内径(LVEDd)、左室舒张末期容积(LVEDV)、左室收缩末期内径(LVESd)、左室收缩末期容积(LVESV)、左室射血分数(LVEF)]、血管内皮功能指标[肱动脉内皮依赖性舒张功能(FMD)、内皮素1、一氧化氮(NO)]、凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)]以及主要心血管不良事件(MACE)发生率。结果经治疗后,治疗组总有效率92.75%(64/69),显著高于对照组的76.81%(53/69)(P<0.05);与治疗前相比,治疗后两组心功能指标LVEDd、LVESd、LVESV、LVEDV水平降低,LVEF水平升高,治疗后治疗组LVEDd、LVESd、LVESV、LVEDV水平较对照组低,LVEF水平较对照组高(P<0.05);治疗后两组血管内皮功能指标FMD、NO水平显著升高,内皮素1水平显著降低,治疗组FMD、NO水平高于对照组,而内皮素1低于对照组(P<0.05);治疗后两组APTT、PT、TT均升高,治疗组高于对照组(P<0.05);随访6个月内,治疗组MACE发生率7.25%(5/69),低于对照组的18.84%(13/69)(P<0.05)。结论沙库巴曲缬沙坦联合比伐芦定治疗PCI术后患者,能够提高临床疗效,改善心功能和血管内皮功能,延长凝血时间,降低MACE发生率。Objective To explore the implications of sacubactril/valsartan combined with bivalirudin on vascular endothelial function and prognosis of coronary heart disease after percutaneous coronary intervention(PCI).Methods A total of 138 patients admitted after PCI from March 2020 to October 2023 were selected and divided into the control group(n=69)and the treatment group(n=69)according to the random envelope method.The control group was treated with conventional drugs(aspirin enteric-coated tablets,metoprolol tartrate tablets,atorvastatin calcium tablets),and the treatment group was treated with sacubattril/valsartan combined with bivalirudin.The clinical efficacy,cardiac function indexes[left ventricular enddiastolic diameter(LVEDd),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic diameter(LVESd),left ventricular endsystolic volume(LVESV),left ventricular ejection fraction(LVEF)]and vascular endothelial function indexes[brachial artery endothelium-dependent vasodilation(FMD),endothelin-1,nitric oxide(NO)],indicators of coagulation function[activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT)],and major adverse cardiovascular events(MACE)were detected and compared between the two treatment groups.Results After treatment,the overall effective rate of the treatment group was 92.75%(64/69),which was significantly higher than 76.81%(53/69)in the control group(P<0.05).Compared with the level before treatment,the levels of cardiac function indexes(LVEDd,LVESd,LVESV and LVEDV)decreased and LVEF increased in the two groups.Compared to the control group,the treatment group had lower levels of LVEDd,LVESd,LVESV,LVEDV,and a higher level of LVEF(P<0.05).Compared with the pre-treatment period,the levels of FMD and NO,indicators of vascular endothelial function,were significantly higher and the levels of endothelin 1 were significantly lower in both groups,with lower levels of FMD and NO and higher levels of endothelin 1 in the treatment group compared with the control group(P

关 键 词：沙库巴曲缬沙坦 比伐芦定 冠心病 经皮冠状动脉介入 血管内皮功能 心功能 

分 类 号：R541.4[医药卫生—心血管疾病]