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。
Objective To 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).Methods In 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.Results After 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).Conclusion Sac/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.
作者
王海燕
姜卫星
田丽
傅向华
WANG Hai-yan;JIANG Wei-xing;TIAN Li;FU Xiang-hua(The 5th Department of Cardiology,Handan Central Hospital,Hebei Province,Handan 056002,China;The Second Department of General Surgery,Jizhong Energy Fengfeng Group General Hospital,Hebei Province,Fengfeng 056200,China;The 5th Department of Cardiology,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)
出处
《河北医科大学学报》
CAS
2020年第3期254-258,267,共6页
Journal of Hebei Medical University
关键词
前壁心肌梗死
血管成行术
气囊
冠状动脉
心力衰竭
anterior wall myocardial infarction
angioplasty
balloon
coronary
heart failure
