沙库巴曲缬沙坦钠与缬沙坦对老年冠心病PCI术后患者心肌酶谱NT-proBNP及炎症因子的影响

Effects of Sacubitril/Valsartan Sodium and Valsartan on MyocardialEnzymes, NT-proBNP and Inflammatory Factors in Elderly Patientswith Coronary Heart Disease after PCI

目的:对比沙库巴曲缬沙坦钠与缬沙坦对老年冠心病经皮冠状动脉介入(PCI)术后患者心肌酶谱、氨基末端B型钠尿肽前体(NT-proBNP)及炎症因子的影响。方法:回顾性收集我院2020年1月至2022年1月收治的139例老年冠心病PCI术后患者资料,其中40例接受常规治疗(对照组),50例在常规治疗的基础上接受沙库巴曲缬沙坦钠治疗(沙库巴曲缬沙坦钠组),49例在常规治疗的基础上接受缬沙坦治疗(缬沙坦组)。比较各组治疗前、治疗2个月后心功能、心肌酶谱、NT-proBNP及炎症因子[肿瘤坏死因子(TNF)-α,白细胞介素(IL)-6,C反应蛋白(CRP)]水平,同时记录主要不良心脏事件(MACE)发生率。结果:沙库巴曲缬沙坦钠组治疗前后左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)差值均高于缬沙坦组和对照组(P<0.05);沙库巴曲缬沙坦钠组治疗前后肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH),天冬氨酸氨基转移酶(AST)、NT-proBNP、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6差值均高于缬沙坦组和对照组(P<0.05);沙库巴曲缬沙坦钠组、缬沙坦组和对照组MACE总发生率分别为6.00%、14.29%和27.50%,三组间比较差异有统计学意义(P<0.05)。结论:对于老年冠心病PCI术后患者,相比缬沙坦,采用沙库巴曲缬沙坦钠治疗可改善心功能,使心肌酶谱恢复正常,下调NT-proBNP及炎症因子水平,降低术后MACE发生风险。

Objective:To compare the effects of sacubitril/valsartan sodium and valsartan on myocardial enzymes,N-terminal pro-B-type natriuretic peptide(NT-proBNP),and inflammatory factors in elderly patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods:The data of 139 elderly patients with coronary heart disease after PCI in our hospital from January 2020 to January 2022 were retrospectively collected,of which 40 patients received conventional western medicine treatment after PCI for coronary heart disease(control group),50 treated with Shakubatrac valsartan sodium on the basis of routine treatment(Shakubatrac valsartan sodium group),and 49 treated with valsartan on the basis of routine treatment(valsartan group).The 3 groups were compared in terms of cardiac function,myocardial enzymes,NT-proBNP,and inflammatory factors.The incidence of major adverse cardiac events(MACE)was recorded.Results:The difference in left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),and left ventricular end-diastolic diameter(LVEDD)before and after treatment in the sakubactrovalsartan sodium group were higher than those in valsartan group and the control group(P<0.05).The difference between creatine kinase(CK),creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH)and aspartate aminotransferase(AST),NT-proBNP,tumor necrosis factor(TNF)-αand interleukin(IL)-6 before and after treatment in sakubactrovalsartan sodium group were higher than those in valsartan group and the control group(P<0.05).The total incidence of MACE in the sakubactrovalsartan sodium group,valsartan group,and control group were 6.00%,14.29%and 27.50%,the difference between the 3 groups was statistically significant(P<0.05).Conclusion:For elderly patients with coronary heart disease after PCI,sacubitril/valsartan sodium treatment can improve cardiac function,restore myocardial enzymes,lower the levels of NT-proBNP and inflammatory factors,and reduce the risk of MACE after the operation.