重组人脑利钠肽联合沙库巴曲缬沙坦钠治疗急性心肌梗死并心力衰竭的临床疗效及其对心功能的影响

Clinical efficacy of recombinant human brain natriuretic peptide combined with sacubitril valsartan sodium in the treatment of acute myocardial infarction complicated with heart failure and its influence on cardiac function

目的观察重组人脑利钠肽联合沙库巴曲缬沙坦钠治疗急性心肌梗死并心力衰竭的临床疗效及其对心功能的影响。方法选取2019年6月—2021年6月南华大学附属长沙中心医院收治的急性心肌梗死并心力衰竭患者68例,按照随机数字表法分为对照组与试验组,各34例。对照组予以沙库巴曲缬沙坦钠,试验组在对照组基础上予以重组人脑利钠肽,2组均治疗4周。比较2组临床疗效,治疗前及治疗4周心功能指标[左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)]、血清心肌损伤标志物指标[N末端脑钠肽前体(NT-proBNP)、肌酸激酶同工酶(CK-MB)与心肌肌钙蛋白T(c Tn T)]、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)]及不良反应。结果试验组治疗总有效率为94.12%,高于对照组的76.47%(χ^(2)=4.220,P=0.039)。治疗4周后,2组LVESD、LVEDD小于治疗前,LVEF高于治疗前,且试验组LVESD、LVEDD小于对照组,LVEF高于对照组(P<0.01)。治疗4周后,2组NT-proBNP、CK-MB、c Tn T、MDA水平低于治疗前,SOD水平高于治疗前,且试验组优于对照组(P<0.01)。试验组不良反应总发生率为11.76%,与对照组的5.88%比较,差异无统计学意义(χ^(2)=0.731,P=0.669)。结论重组人脑利钠肽联合沙库巴曲缬沙坦钠治疗急性心肌梗死并心力衰竭的临床疗效确切,可有效改善心功能,减轻心肌损伤,降低氧化应激反应,且安全性较高。

Objective To observe clinical efficacy of recombinant human brain natriuretic peptide combined with sacubitril valsartan sodium in the treatment of acute myocardial infarction complicated with heart failure and its influence on cardiac function.Methods A total of 68 cases of patients with acute myocardial infarction complicated with heart failure were selected from June 2019 to June 2021 in Changsha Central Hospital Affiliated to Nanhua University,which were randomly divided into control group and experimental group according to the random number method,with 34 cases in each group.The control group was given sacubitril valsartan sodium,and the experimental group was given recombinant human brain natriuretic peptide on the basis of the control group.Both groups were treated for 4 weeks.Clinical efficacy,heart function indexes(LVESD,LVEDD,LVEF),serum myocardial injury markers(NT-proBNP,CK-MB,c Tn T)and oxidative stress indexes(SOD,MDA)before and after 4 weeks of treatment were compared between the two groups,and the incidence of adverse reactions were observed.Results The total effective rate of the experimental group was 94.12%,which was higher than76.47%of the control group(χ^(2)=4.220,P=0.039).After 4 weeks of treatment,LVESD and LVEDD in the two groups were lower than before treatment,LVEF was higher than before treatment,and LVESD and LVEDD in the experimental group were lower than those in the control group,and LVEF was higher than that in the control group(P<0.01).After 4 weeks of treatment,the levels of NT pro BNP,CK-MB,c Tn T and MDA in the two groups were lower than those before treatment,SOD leve was higher than that before treatment,and those in the experimental group were better than those in the control group(P<0.01).The total incidence of adverse reactions in the experimental group was 11.76%,which was not statistically significant compared with 5.88%in the control group(χ^(2)=0.731,P=0.669).Conclusion Recombinant human brain natriuretic peptide combined with sacubitril valsartan sodium have an exact clinical effect for acute myocardial infarction complicated with heart failure,which can effectively improve cardiac function,reduce myocardial damage and oxidative stress response,and has high safety.