沙库巴曲缬沙坦对急性前壁ST段抬高型心肌梗死PCI术后心力衰竭患者心功能的影响

doi:10.3969/j.issn.1007-3205.2020.03.002

河北医科大学学报

沙库巴曲缬沙坦对急性前壁ST段抬高型心肌梗死PCI术后心力衰竭患者心功能的影响

1.河北省邯郸市中心医院心内五科，河北邯郸 056002；2.冀中能源峰峰矿区总医院普外二科，
河北峰峰 056200；3.河北医科大学第二医院心内五科，河北石家庄 050000

出版日期:2020-03-25 发布日期:2020-04-02
作者简介:王海燕(1982-)，女，河北邯郸人，河北省邯郸市中心医院主治医师，医学博士研究生，从事心血管内科疾病诊治研究。

Effects of Sacubitril/Valsartan on cardiac function in patients with acute anterior wall ST-segment elevation myocardial infarction after PCI with reduced ejection fraction

1.The 5th Department of Cardiology, Handan Central Hospital, Hebei Province, Handan 056002, China;
2.The Second Department of General Surgery, Jizhong Energy Fengfeng Group General Hospital, Hebei
Province, Fengfeng 056200, China; 3.The 5th Department of Cardiology, the Second
Hospital of Hebei Medical University, Shijiazhuang 050000, China

Online:2020-03-25 Published:2020-04-02

摘要/Abstract

摘要： ［摘要］
目的探讨沙库巴曲缬沙坦（Sacubitril/Valsartan, Sac/Val）对急性前壁ST段抬高型心肌梗死（ST-segment myocardial infarction, STEMI）经皮冠状动脉介入治疗( percutaneous coronary intervention,PCI)术后合并射血分数降低心力衰竭（heart failure with reduced ejection fraction,HFrEF）患者心功能的影响。
方法前瞻性、随机对照研究，连续入选急性前壁STEMI于PCI术后合并HFrEF患者160例，随机分为观察组（n=80例）和对照组（n=80例）。PCI术后1周，对照组常规治疗基础上给予缬沙坦（Valsartan,Val），观察组在常规治疗基础上给予Sac/Val治疗6个月。比较2组血浆N-末端脑利钠肽(N-terminal brain natriuretic peptide,NT-proBNP)浓度及超声心动图参数变化。评估Sac/Val对急性前壁STEMI于PCI术后合并HFrEF患者心功能的影响。
结果随访6个月结果显示,2组NT-proBNP、左心室射血分数(left ventricular ejection fraction, LVEF)、室壁运动积分(wall motion score index, WMSI)均较基线明显改善观察组上述指标改善更显著（P＜0.001）。随访结束时，观察组左心室收缩末容积(left ventricular final systolic volume, LVESV)明显缩小（P＜0.05），主要不良心脏事件（major adverse cardiac event,MACE）明显降低（P＜0.05）。
结论 Sac/Val可以改善急性前壁STEMI于PCI术后合并HFrEF患者的室壁运动障碍，提高左心功能，降低6个月内的MACE。

关键词: 前壁心肌梗死, 血管成行术, 气囊, 冠状动脉, 心力衰竭

Abstract: ［Abstract］ ObjectiveTo investigate the effects of Sacubitril/Valsartan(Sac/Val) on cardiac function in patients with acute anterior wall ST-segment myocardial infarction(STEMI) complicated with heart failure with reduced ejection fraction(HFrEF).
〖WTHZ〗MethodsIn a prospective, randomized controlled study, 160 consecutive cases of acute anterior wall STEMI patients complicated with HFrEF after PCI were enrolled, and divided into the observation group(n=80) and the control group(n=80) using a randomized digital method. At one week after PCI, the control group received routine treatment and Valsartan(Val), while the observation group was given Sac/Val in addition to routine treatment, for a duration of 6 months treatment. Changes of plasma NT-proBNP concentration and echocardiography parameters were compared between two groups. The effect of Sac/Val in acute anterior STEMI patients with HFrEF after PCI was evaluated.
〖WTHZ〗ResultsAfter 6 months of follow-up, NT-proBNP, LVEF and WMSI were significantly improved compared with baseline in two groups(P＜0.001). However, the above indicators improved more significantly in the observation group. At the end of the follow-up, the left ventricular end systolic volume (LVESV) decreased significantly, and the major adverse cardiac events(MACE) were significantly reduced in the observation group(P＜0.05).
〖WTHZ〗ConclusionSac/Val can improve ventricular wall dyspraxia and improved left cardiac function and reduced MACE within 6 months after PCI in patients with acute anterior STEMI complicated with HFrEF.

Key words: anterior wall myocardial infarction, angioplasty, balloon, coronary, heart failure

王海燕1，姜卫星2，田丽1，傅向华3. 沙库巴曲缬沙坦对急性前壁ST段抬高型心肌梗死PCI术后心力衰竭患者心功能的影响[J]. 河北医科大学学报, doi: 10.3969/j.issn.1007-3205.2020.03.002.

WANG Hai-yan1, JIANG Wei-xing2, TIAN Li1, FU Xiang-hua3. Effects of Sacubitril/Valsartan on cardiac function in patients with acute anterior wall ST-segment elevation myocardial infarction after PCI with reduced ejection fraction[J]. Journal of Hebei Medical University, doi: 10.3969/j.issn.1007-3205.2020.03.002.

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沙库巴曲缬沙坦对急性前壁ST段抬高型心肌梗死PCI术后心力衰竭患者心功能的影响

Effects of Sacubitril/Valsartan on cardiac function in patients with acute anterior wall ST-segment elevation myocardial infarction after PCI with reduced ejection fraction

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