托伐普坦治疗急性心肌梗死合并心力衰竭的疗效及对心肾功能的影响

The Effect of Topavtan on Acute Myocardial Infarction and Heart Failure and its Effect on Cardiac and Renal Function

目的探讨托伐普坦治疗急性心肌梗死合并心力衰竭的疗效及对心肾功能的影响。方法选择2017年4月至2019年2月136例急性心肌梗死合并心力衰竭患者,随机分为两组各68例。对照组予以常规治疗,研究组同时加用托伐普坦治疗。比较两组治疗后左心室射血分数(LVEF)、左心室舒张末期内径(LVDd)、心搏出量(CO)、二尖瓣E波峰值流速/A波峰值流速(E/A),血肌酐(SCr)、尿素氮(BUN)及胱抑素C(CysC),血浆氨基末端前体脑钠肽(NT-proBNP)和内皮素-1(ET-1)水平,并观察30 d内的主要心脏事件(MACE)。结果治疗后,研究组LVEF、LVDd、CO、E/A明显优于对照组,比较具有统计学意义(P<0.05)。研究组Scr、CysC、BUN与对照组比较无具有统计学意义(P>0.05)。研究组血浆NT-proBNP、ET-1水平明显低于对照组,比较具有统计学意义(P<0.05)。研究MACE发生率为10.3%,对照组MACE发生率为36.8%,比较具有统计学意义(P<0.05)。结论托伐普坦能有效改善急性心肌梗死合并心力衰竭患者的心功能,降低心脏事件的危险,且对肾功能无不良影响。

Objective To investigate the effect of topavtan on acute myocardial infarction and heart failure and its effect on cardiac and renal function. Methods A total of 136 patients with acute myocardial infarction and heart failure from April 2017 to February 2019 were selected and randomly divided into two groups with 68 cases each.The control group received routine treatment, while the study group received topvastatin. After treatment, left ventricular ejection fraction(LVEF), left ventricular end diastolic diameter(LVDd), cardiac output(CO), mitral valve e-wave velocity/A wave peak velocity(E/A), blood creatinine(SCr), urea nitrogen(BUN) and cystatin C(CysC), plasma aminoterminal precursor brain natriuretic peptide(nt-probnp) and endothelin-1(et-1) levels were compared between the two groups.Major cardiac events(MACE) were observed for 30 days. Results After treatment, LVEF, LVDd, CO and E/A in the study group were significantly better than those in the control group, and the comparison were statistical significance(P<0.05). Scr, CysC and BUN of the study group were not statistically significant compared with the control group(P>0.05). The plasma levels of NT-proBNP and ET-1 in the study group were significantly lower than those in the control group, and the comparison were statistical significance(P<0.05). The incidence of MACE in the study was 10.3%, and 36.8% in the control group, and the comparison were statistical significance(P<0.05). The incidence of MACE in the study was 10.3%, and 36.8% in the control group,and the comparison were statistical significance(P<0.05). Conclusion Topalptan can effectively improve the cardiac function of patients with acute myocardial infarction and heart failure, reduce the risk of cardiac events, and have no adverse effect on renal function.