沙库巴曲/缬沙坦联合曲美他嗪对急诊经皮冠状动脉介入术后患者心功能的影响

Impacts of sacubitril/valsartan combined with trimetazidine on cardiac function of patients after emergency percutaneous coronary intervention

目的观察急诊经皮冠状动脉介入手术(PCI)后患者联合使用沙库巴曲/缬沙坦和曲美他嗪对心功能的改善作用。方法入选2016年1月到2020年6月在我院接受急诊PCI的急性心肌梗死(AMI)患者110例,随机分为联合治疗组(55例)和对照组(55例)。对照组给予曲美他嗪治疗,联合治疗组给予沙库巴曲/缬沙坦联合曲美他嗪治疗,随访3个月。在术后第7天和3个月时分别测定左室射血分数(LVEF)、左室舒张末容积(LVEDD)、氨基末端脑钠肽前体(NT-proBNP)和6 min步行试验。结果两组患者术后7 d LVEF、LVEDD、NT-proBNP和6 min步行试验比较,差异无统计学意义(P>0.05)。组内随访至术后3个月,与术后7 d比较两组患者LVEF明显增加,LVEDD明显降低,而6 min步行试验距离明显增加(P<0.05),NT-proBNP水平则明显降低(P<0.05);术后3个月,联合治疗组患者LVEF较对照组明显增加(P<0.05),LVEDD和NT-pro BNP水平明显降低(P<0.05),6 min步行距离较对照组明显增加(P<0.05)。结论急诊PCI患者联合使用沙库巴曲/缬沙坦和曲美他嗪能够进一步改善心功能,提高患者运动耐量,值得临床推广。

Objective To observe the improvement of sacubitril/valsartan combined with trimetazidine on cardiac function of patients after emergency percutaneous coronary intervention(PCI).Methods A total of 110 patients with acute myocardial infarction(AMI)undergoing emergency PCI admitted to our hospital from January 2016 to June 2020 were selected and randomly divided into the combined treatment group(n=55)and the control group(n=55).The control group was treated with trimetazidine,and the combined treatment group was treated with sacubitril/valsartan combined with trimetazidine.All of them were followed up for 3 months.On the 7 th day and 3 rd month after operation,the left ventricular ejection fraction(LVEF),the left ventricular end diastolic volume(LVEDD),the N-terminal pro brain natriuretic peptide(NT-proBNP)and the 6-minute walking test were measured.Results After 7 days of operation,there were no statistically significant differences in the LVEF,LVEDD,NT-proBNP and 6-minute walking test between the two groups of patients(P>0.05).Compared with 7 days after operation,LVEF of the two groups of patients increased significantly,LVEDD decreased significantly,and the 6-minute walking distance increased significantly(P<0.05),while NT-proBNP level decreased significantly in 3 months after operation(P<0.05).3 months after operation,the LVEF of the combined treatment group was significantly higher than that of the control group(P<0.05).The LVEDD and NT-proBNP levels of the combined treatment group were significantly lower than those of the control group(P<0.05),while the 6-minute walking distance of the combined treatment group were significantly higher than those of the control group(P<0.05).Conclusion The combined use of sacubitril/valsartan and trimetazidine in patients with emergency PCI can further improve cardiac function and exercise tolerance,which is worthy of clinical promotion.