摘要
目的探讨急性心肌梗死合并急性心力衰竭患者经皮冠状动脉介入治疗(PCI)后早期应用沙库巴曲缬沙坦的临床效果。方法前瞻性纳入2018年6月至2022年10月商丘市第一人民医院收治的65例急性心肌梗死合并急性心力衰竭患者,经随机数字表法将患者分为对照组35例与观察组30例。两组患者均接受早期PCI治疗,术后对照组口服盐酸贝那普利,观察组口服沙库巴曲缬沙坦,连续治疗8周。对比两组患者治疗总有效率、治疗前和治疗8周时的心功能指标[左心室射血分数(LVEF)、左室舒张末期内径(LVEDD)和血清脑利钠肽前体(NT-proBNP)]、心肌损伤标志物[肌酸激酶同工酶MB(CK-MB)、肌红蛋白(Myo)],比较治疗期间发生的不良反应情况。结果观察组总有效率(93.33%,28例)高于对照组(71.43%,25例),差异有统计学意义(χ^(2)=5.149,P<0.05);两组患者的LVEF升高,且观察组(48.52±3.28)%高于对照组(43.86±2.52)%(t=13.434,P<0.05),LVEDD与NT-proBNP均降低,观察组分别为(46.70±2.88)mm和(680.44±87.04)pg/L低于对照组的(50.46±3.47)mm和(1715.94±115.41)pg/L(t值分别为5.287、5.330,均P<0.05);两组患者CK-MB、Myo较治疗前均降低,观察组分别为(31.42±5.76)U/L、(34.42±5.36)mg/L,低于对照组(38.44±4.94)U/L、(43.15±7.46)mg/L,差异有统计学意义(t值分别为5.287、5.330,均P<0.05);观察组不良反应发生率(16.67%,5例)低于对照组(28.57%,10例),差异无统计学意义(χ^(2)=1.290,P>0.05);观察组再入院率(10.00%,3例)低于对照组(14.29%,5例),差异亦无统计学意义(χ^(2)=0.021,P>0.05)。结论PCI后早期应用沙库巴曲缬沙坦可有效改善急性心肌梗死合并急性心力衰竭患者心功能,促进心肌细胞的修复,提高术后治疗效果。
Objective To examine the clinical effect of early administration of Shakubatracvalsartan following early percutaneous coronary intervention(PCI)in patients diagnosed with acute myocardial infarction and acute heart failure.Methods This study prospectively included 65 patients with acute myocardial infarction and acute heart failure who were admitted to the First People's Hospital of Shangqiu from June 2018 to October 2022.The patients were randomly divided into two groups:the control group(35 cases)and the observation group(30 cases).Both groups received early PCI treatment.After the operation,the control group received oral administration of Benazepril hydrochloride,while the observation group received oral administration of Shakubatracvalsartan for a duration of 8 weeks.The study compared the total treatment efficiency and cardiac function parameters,such as left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),and clear brain natriuretic peptide precursor(NT-proBNP)as well as myocardial injury markers(creatine kinase isoenzyme MB(CK-MB)and myoglobin(Myo))before and at 8 weeks of treatment between the two groups.Additionally,any adverse effects that occurred during the treatment period were also compared.Results The total effective rate was 93.33%(28 cases)in the observation group and 71.43%(25 cases)in the control group.The observation group had a higher rate compared to the control group,and this difference was statistically significant(χ^(2)=5.149,P<0.05).Both groups showed an increase in left ventricular ejection fraction,a decrease in left ventricular end-diastolic diameter,and a decrease in N-terminal pro-brain natriuretic peptide.In the observation group,the left ventricular ejection fraction was(48.52±3.28)%,which was higher than the control group's(43.86±2.52)%,and the left ventricular end-diastolic diameter was(46.70±2.88)mm and the N-terminal pro-brain natriuretic peptide was(680.44±87.04)pg/L,which were lower than the control group's(50.46±3.47)mm and(1715.94�
作者
李曼
王勇
王志建
白智峰
Li Man;Wang Yong;Wang Zhijian;Bai Zhifeng(Department of Cardiology,First People's Hospital of Shangqiu,Shangqiu 476100,China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2023年第9期1047-1051,共5页
Chinese Journal of Geriatrics
基金
河南省医学科技攻关计划项目(LHGJ20210987)。
关键词
心肌梗死
心力衰竭
血管成形术
经腔
经皮冠状动脉
沙库巴曲缬沙坦
Acute myocardial infarction
Acute heart failure
Augioplasty,Transluminal,percutaneous coronary intervention
Shakubatracvalsartan
