沙库巴曲缬沙坦在急性心肌梗死后心力衰竭防治中的临床效果评价

Evaluation of clinical effect of sacubitril and valsartan in the prevention and treatment of heart failure after acute myocardial infarction

目的分析沙库巴曲缬沙坦对急性心肌梗死后心力衰竭的防治作用。方法82例急性心肌梗死患者,按照接诊时间先后分为对照组和观察组,每组41例。对照组患者采取美托洛尔治疗,观察组患者在对照组基础上加用沙库巴曲缬沙坦治疗。比较两组患者临床治疗效果及心力衰竭发生情况,治疗前后心功能指标[左室射血分数(LVEF)、每搏输出量(SV)、心输出量(CO)、6 min步行距离试验(6MWT)]。结果观察组临床治疗总有效率为95.1%(39/41),高于对照组的73.2%(30/41),差异有统计学意义(P<0.05)。观察组患者治疗后心力衰竭发生率7.3%(3/41)低于对照组的26.8%(11/41),差异有统计学意义(P<0.05)。治疗前,两组患者的LVEF、SV、CO、6MWT比较差异无统计学意义(P>0.05);治疗后,两组患者的LVEF、SV、CO、6MWT均优于本组治疗前,且观察组患者的LVEF(48.9±3.8)%、SV(66.9±2.7)ml、CO(5.1±0.2)L/min、6MWT(382.9±22.1)m均明显优于对照组的(41.3±3.4)%、(61.8±4.7)ml、(4.3±0.3)L/min、(351.9±18.7)m,差异具有统计学意义(P<0.05)。结论急性心肌梗死患者采用沙库巴曲缬沙坦治疗可明显提高临床治疗效果,改善患者心功能状态,对预防心力衰竭具有显著效果。

Objective To analyze the effect of sacubitril and valsartan in the prevention and treatment of heart failure after acute myocardial infarction.Methods A total of 82 patients with acute myocardial infarction were divided into control group and observation group according to the time of admission,with 41 cases in each group.Patients in the control group were treated with metoprolol,and patients in the observation group were additionally treated with sacubitril and valsartan on the basis of the control group.The clinical effect,occurrence of heart failure,and cardiac function indexes[left ventricular ejection fraction(LVEF),stroke volume(SV),cardiac output(CO),and 6-min walking test(6MWT)]before and after treatment were compared between the two groups.Results The total effective rate of clinical treatment in the observation group was 95.1%(39/41),which was higher than 73.2%(30/41)in the control group,and the difference was statistically significant(P<0.05).After treatment,the incidence of heart failure in the observation group was 7.3%(3/41),which was lower than 26.8%(11/41)in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in LVEF,SV,CO and 6MWT between the two groups(P>0.05).After treatment,the LVEF,SV,CO,and 6MWT of the two groups were better than those of this group before treatment;the LVEF(48.9±3.8)%,SV(66.9±2.7)ml,CO(5.1±0.2)L/min,6MWT(382.9±22.1)m in the observation group were significantly better than(41.3±3.4)%,(61.8±4.7)ml,(4.3±0.3)L/min,(351.9±18.7)m in the control group;all the differences were statistically significant(P<0.05).Conclusion The treatment of patients with acute myocardial infarction with sacubitril and valsartan can significantly enhance the clinical therapeutic effect,improve the cardiac function of patients,and has a significant effect on the prevention of heart failure.