沙库巴曲缬沙坦钠片对缺血性心肌病合并心房颤动患者心功能和NT-pro BNP水平的影响

Effects of sacubitril and valsartan sodium tablets on ischemic cardiomyopathy complicated with atrial fibrillation on cardiac function and NT-pro BNP level

目的探究与分析沙库巴曲缬沙坦钠片对缺血性心肌病合并心房颤动对心功能和N末端脑钠肽前体(NT-proBNP)水平的影响。方法选取2019年2月至2021年1月江苏盛泽医院收治的缺血性心肌病合并心房颤动患者120例作为研究对象,按随机数字表法分成观察组和对照组,各60例。对照组给予地高辛、氢氯噻嗪、卡托普利、阿托伐汀、阿司匹林个性化治疗方案,在其基础上,观察组将卡托普利替换为沙库巴曲缬沙坦钠片,两组均连续治疗3个月。对比两组患者的临床疗效、治疗前后心功能及运动功能指标、血清NTpro BNP水平,随访6个月不良心血管事件发生率。结果观察组与对照组相比总有效率较高,随访6个月内不良心血管事件发生率较低,差异有统计学意义(P<0.05)。观察组治疗后与对照组治疗后相比LVESD较低、LVEF较高、LVEDD较低、CO较高、SV较高,6 min步行距离较高,NT-proBNP较低,差异有统计学意义(P<0.05)。结论沙库巴曲缬沙坦钠片对缺血性心肌病合并心房颤动可更好地改善患者的临床症状及体征,获得更好的心功能及运动功能,同时可调节患者的血清NT-pro BNP水平,短期不良心血管事件发生率较低,安全性较高。

Objective To explore and analyze the effect of sacubitril-valsartan sodium tablet on ischemic cardiomyopathy complicated with atrial fibrillation on cardiac function and N-terminal pro-brain natriuretic peptide(NT-pro BNP)level.Methods The random number table method was used to divide 120 patients with ischemic cardiomyopathy and atrial fibrillation admitted in the Jiangsu Shengze Hospital from February 2019 to January 2021,60 cases in each group,and the control group was given personalized treatment including digoxin,hydrochlorothiazide,captopril,atorvatin,aspirin on the basis of which,the observation group replaced captopril with sacubitril-valsartan sodium tablets,and both groups were treated for 3 consecutive months.The clinical efficacy,cardiac function and motor function indexes,and serum NT-pro BNP levels before and after treatment were compared between the two groups,and the incidence of adverse cardiovascular events was recorded after a 6-mouth follow-up.Results Compared with the control group,the observation group had a higher total effective rate and a lower incidence of adverse cardiovascular events within 6 months of follow-up,and the difference was statistically significant(P<0.05).Compared with the control group after treatment,the observation group had lower LVESD,higher LVEF,lower LVEDD,higher CO,higher SV,higher 6-min walking distance,and lower NT-proBNP,and the differences were statistically significant(P<0.05).Conclusion Sacubitril and Valsartan sodium tablets can better improve the clinical symptoms and signs of patients with ischemic cardiomyopathy complicated with atrial fibrillation,obtain better cardiac function and motor function,and can regulate the serum NT-Pro BNP level,the incidence of short-term adverse cardiovascular events is lower,and the safety is higher.