环磷腺苷葡胺结合磷酸肌酸钠治疗急性心肌梗死伴心力衰竭患者的效果及对CPP、sNEP表达的影响

Efficacy of meglumine cyclic adenosine phosphate combined with sodium creatine phosphate in the treatment of patients with acute myocardial infarction and heart failure and its influence on the expression of CPP and sNEP

目的研究环磷腺苷葡胺结合磷酸肌酸钠治疗急性心肌梗死伴心力衰竭患者的疗效及对血清和肽素(copeptin,CPP)、脑啡肽酶(neprilysin,NEP)表达的影响。方法选取我院收治的急性心肌梗死伴心力衰竭患者134例,按照数字随机表法分为对照组(67例)和观察组(67例),均接受常规治疗,其中对照组采用环磷腺苷葡胺治疗,观察组采用环磷腺苷葡胺结合磷酸肌酸钠治疗。比较两组的疗效,以及心功能、冠状动脉血流动力学以及血清CPP、NEP的变化,并统计随访1个月期间主要不良心血管事件情况。结果观察组治疗有效率高于对照组(P<0.05)。2组经治疗后冠状动脉血流动力学指标均增加,治疗后观察组收缩期峰流速、左前降支的舒张期峰流速、时间速度积分均高于对照组(P<0.05)。2组治疗后左心室舒张末期容积、左心室收缩末期容积均降低,而左心室射血分数明显增加,其中观察组治疗后各指标水平优于对照组(P<0.05)。2组治疗后血清CPP、NEP均降低,其中观察组治疗后各指标均低于对照组(P<0.05)。随访1个月,主要不良心血管事件主要为心绞痛、心肌梗死以及再发心力衰竭,其中观察组主要不良心血管事件发生率低于对照组(P<0.05)。结论环磷腺苷葡胺结合磷酸肌酸钠治疗急性心肌梗死伴心力衰竭疗效显著,可降低血清CPP、NEP水平,改善冠状动脉血流动力学状态以及心功能,降低主要不良心血管事件风险,安全性较好。

Objective To study the efficacy of meglumine cyclic adenosine phosphate combined with sodium creatine phosphate in the treatment of patients with acute myocardial infarction(AMI)and heart failure and its influence on the expression of copeptin(CPP)and neprilysin(sNEP).Methods A total of 134 patients with AMI and heart failure in our hospital were divided into control group(n=67)and observation group(n=67)according to the random number table method.They all received conventional treatment.The control group was treated with meglumine cyclic adenosine monophosphate,and the observation group was treated with meglumine cyclic adenosine monophosphate combined with sodium creatine phosphate.The curative effects,cardiac function,coronary hemodynamics,and changes in serum CPP and NEP of the two groups were compared,and the main adverse cardiovascular events during one-month follow-up were recorded.Results The effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the indexes of coronary hemodynamics in the two groups increased,and the systolic peak velocity,diastolic peak velocity and time velocity integral in the observation group were higher than those in the control group(P<0.05).After treatment,left ventricular end diastolic volume and left ventricular end systolic volume decreased,while left ventricular ejection fraction increased significantly;the levels of indexes in the observation group were better than those in the control group(P<0.05).After treatment,the serum CPP and NEP decreased,which were lower in the observation group than in the control group(P<0.05).The main adverse cardiovascular events were angina pectoris,myocardial infarction and recurrent heart failure within one-month follow-up,and the incidence of major adverse cardiovascular events in the observation group was lower than that in the control group(P<0.05).Conclusion Meglumine adenosine cyclophosphate combined with creatine phosphate sodium in the treatment of AMI with heart failure has a significant curative effect.It can reduce the serum levels of CPP and NEP,improve coronary hemodynamic status and cardiac function,and reduce the risk of major adverse cardiovascular events,with good safety.