沙库巴曲缬沙坦联合螺内酯治疗急性心肌梗死直接经皮冠状动脉介入后心力衰竭的效果

Effect of Sacubitril Valsartan Combined with Spironolactone in Treatment of Heart Failure After Direct Percutaneous Coronary Intervention for Acute Myocardial Infarction

目的:探讨沙库巴曲缬沙坦联合螺内酯治疗急性心肌梗死(AMI)直接经皮冠状动脉介入(PCI)后心力衰竭的效果。方法:选取2020年4月—2022年4月荷泽市单县中心医院收治的AMI直接PCI后心力衰竭患者80例为研究对象,依据随机数字表法分为对照组和研究组,各40例。对照组采用依那普利联合螺内酯治疗,研究组采用沙库巴曲缬沙坦联合螺内酯治疗。比较两组患者血浆N-端脑钠肽前体激素(NT-proBNP)水平、血压及心率水平、不良反应发生情况。结果:治疗后,两组患者NT-proBNP水平均降低,研究组低于对照组,差异有统计学意义(P<0.001);治疗后,两组收缩压、舒张压、心率均优于治疗前,研究组心率低于对照组,差异有统计学意义(P<0.05);治疗后,两组收缩压、舒张压水平比较,差异无统计学意义(P>0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:沙库巴曲缬沙坦联合螺内酯治疗AMI直接PCI后心力衰竭患者,可以改善NT-proBNP水平,相对安全,但对血压方面的改善效果并不明显。

Objective:To investigate the effect of sacubitril valsartan combined with spironolactone in the treatment of heart failure after direct percutaneous coronary intervention(PCI)for acute myocardial infarction(AMI).Methods:A total of 80 patients with heart failure after direct PCI for AMI who were admitted to Shanxian Central Hospital from April 2020 to April 2022 were selected as the study subjects.They were divided into control group and study group according to random number table method,with 40 cases in each group.The control group was treated with enalapril combined with spironolactone,and the study group was treated with sacubitril valsartan combined with spironolactone.The levels of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP),blood pressure,heart rate and adverse reactions were compared between the two groups.Results:After treatment,the levels of NT-proBNP was decreased in both groups,and the levels in the study group were lower than those in the control group,the difference was statistically significant(P<0.001);After treatment,the systolic blood pressure,diastolic blood pressure and heart rate in the two groups were better than those before treatment,the heart rate in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05);There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05);After treatment,there was no significant difference in the levels of systolic blood pressure and diastolic blood pressure between the two groups(P>0.05).Conclusion:Sacubitril valsartan combined with spironolactone in the treatment of heart failure after direct PCI for AMI can improve the levels of NT-proBNP,this therapy is relatively safe,but the improvement effect on blood pressure is not obvious.