沙库巴曲缬沙坦钠治疗急性心肌梗死PCI术后心力衰竭患者的临床研究OACSTPCD
Clinical trial of sacubitril/valsartan sodium on the patients with heart failure in acute myocardial infarction after PCI
目的 探究沙库巴曲缬沙坦治疗急性心肌梗死(AMI)经皮冠状动脉介入术(PCI)术后心力衰竭的效果.方法 将接受PCI术治疗的AMI患者随机分为试验组和对照组.2组患者均给予抗血小板聚集、调脂、β-受体阻滞药、利尿药等常规基础治疗,对照组在基础治疗上给予马来酸依那普利片(5 mg,bid),试验组在基础治疗上给予沙库巴曲缬沙坦钠片(5 mg,bid).比较2组患者的临床疗效、心肌损伤标志物、心功能、心室重构指标、血管内皮功能和心血管不良事件(MACEs).结果 试验组和对照组分别入组40例.治疗3个月后,试验组总有效率为95.00％,对照组为80.00％,在统计学上差异有统计学意义(P＜0.05).治疗3个月后,试验组和对照组肌酸激酶同工酶(CK-MB)水平分别为(30.23±5.28)和(36.58±7.05)U·L-1,心肌肌钙蛋白 Ⅰ(cTn Ⅰ)分别为(1.04±0.18)和(1.25±0.31)ng·mL-1,左心室射血分数(LVEF)分别为(40.29±6.32)％和(34.39±5.62)％,肱动脉内皮依赖性舒张功能(FMD)分别为(15.72±2.83)％和(9.55±2.05)％,一 氧化氮(NO)水平分别为(47.41±5.85)和(41.28±3.37)μmol·L-1,内皮素 1(ET-1)分别为(70.53±8.29)和(83.62±10.11)ng·L-1,试验组的上述指标与对照组比较,在统计学上差异均有统计学意义(均P＜0.05).试验组的MACEs发生率为10.00％,对照组为25.00％,在统计学上差异无统计学意义(P＞0.05).治疗3个月后,试验组AMI患者药物不良反应发生率为12.50％,对照组药物不良反应发生率为17.50％,试验组的药物不良反应发生率与对照组比较,在统计学上差异无统计学意义(P＞0.05).结论 沙库巴曲缬沙坦可具备治疗AMI患者PCI术后心力衰竭的效果,能够有效抗心室重构,改善血管内皮功能.
Objective To investigate the effect of sakubatrotril and valsartan in the treatment of heart failure after percutaneous coronary intervention(PCI)for acute myocardial infarction(AMI).Methods AMI patients who received PCI were randomly divided into treatment group and control group.Both groups were given routine basic treatment such as anti-platelet aggregation,lipidregulation,β-blocker and diuretic tolasemide,while the control group was given enalapril maleate tablet(5 mg,bid).The treatment group was given sacubactril valsartan sodium tablets(5 mg,bid)in addition to basic treatment.The clinical efficacy,myocardial injury markers,cardiac function,ventricular remodeling indexes,vascular endothelial function and cardiovascular adverse events(MACEs)were compared between the two groups.Results The treatment group and the control group were enrolled in 40 patients.After 3 months of treatment,the total effective rate of the treatment group was 95.00％and that of the control group was 80.00％.The difference between the total effective rate of the treatment group and the control group was statistically significant(P＜0.05).After 3 months of treatment,the levels of creatine kinase isoenzyme(CK-MB)in treatment group and control group were(30.23±5.28)and(36.58±7.05)U·L-1,respectively;cardiac troponin Ⅰ(cTnⅠ)were(1.04±0.18)and(1.25±0.31)ng·mL-1,respectively;left ventricular ejection fraction(LVEF)were(40.29±6.32)％and(34.39±5.62)％,and endothelium-dependent diastolic function(FMD)were(15.72±2.83)％and(9.55±2.05)％,respectively;nitric oxide(NO)levels were(47.41±5.85)and(41.28±3.37)μmol·L-1;endothelin-1(ET-1)was(70.53±8.29)and(83.62±10.11)ng·L-1,respectively.Compared with the control group,the above indexes in treatment groups were statistically significant(all P＜0.05).The incidence of MACEs was 10.00％in treatment group and 25.00％in control group,with no statistical significance(P＞0.05).After 3 months of treatment,the incidence of adverse drug reactions in AMI patients in treatment group was 12.50％,and that in control group was 17.50％.There was no statistical significance in the incidence of adverse drug reactions in treatment group compared with control group(P＞0.05).Conclusion Sacubactril valsartan can effectively prevent ventricular remodeling and improve vascular endothelial function in patients with heart failure after PCI.
牛洁婷;王文娟;赵莉;左亮亮;谷倩倩
沧州市中心医院老年医学科,河北 沧州 061000
药学
沙库巴曲缬沙坦经皮冠状动脉介入术急性心肌梗死心力衰竭血管内皮功能心室重构
sacubitril/valsartanpercutaneous coronary interventionacute myocardial infarctionheart failurevascular endothelial functionventricular remodeling
《中国临床药理学杂志》 2024 (002)
160-164 / 5
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