沙库巴曲缬沙坦对行急诊PCI的急性心肌梗死患者左心室重构及预后的影响

Effect of Sacubitril valsartan on left ventricular remodeling and prognosis in patients with acute myocardial infarction after emergency PCI

目的探讨沙库巴曲缬沙坦对行急诊经皮冠状动脉介入术(PCI)的急性心肌梗死患者左心室重构及预后的影响。方法选取2021年2月—2023年2月就诊安阳市人民医院的行急诊PCI的AMI患者114例,随机分为对照组57例和观察组57例,对照组术后给予依那普利治疗,观察组术后给予沙库巴曲缬沙坦治疗,两组连续治疗观察6个月。比较两组治疗前、治疗3个月、治疗6个月的左心室舒张末期内径(LVEDD)、室间隔厚度(IVST)、左心室质量指数(LVMI)、左心室射血分数(LVEF),6 min步行实验(6MWT)以及心血管不良预后事件的发生情况。结果治疗3个月、6个月,两组LVEDD、IVST、LVMI较治疗前降低(P<0.05);且治疗3个月、6个月观察组LVEDD与对照组比较,明显较低(P<0.05),治疗3个月观察组IVST、LVMI与对照组比较,明显较低(P<0.05)。治疗3个月、6个月,两组6MWT、LVEF较治疗前均升高(P<0.05),且观察组6MWT、LVEF与对照组比较,明显较高(P<0.05)。观察组心血管不良预后事件发生率为8.77%,与对照组的26.32%比较明显较低(P<0.05)。结论沙库巴曲缬沙坦对行急诊PCI的急性心肌梗死患者,可有效改善左心室重构和心功能,降低心血管不良预后事件的发生率。

Objective To investigate the effect of Sacubitril/valsartan on left ventricular remodeling and prognosis in acute myocardial infarction(AMI)patients undergoing emergency percutaneous coronary intervention(PCI).Methods Totally 114 patients with AMI after PCI were selected in Anyang People's Hospital from February 2021 to February 2023 and divided into control group(57 cases)and observation group(57 cases)by random number table method.The control group was given enalapril after surgery,and the observation group was given Sacubitril valsartan after surgery for 6 months.The left ventricular end-diastolic diameter(LVEDD),ventricular septum thickness(IVST),left ventricular mass index(LVMI),left ventricular ejection fraction(LVEF),6 min walking test(6MWT),and the incidence of cardiovascular adverse prognosis events were compared between the two groups before treatment,3 months and 6 months of treatment.Results LVEDD,IVST,and LVMI in both groups decreased compared to before treatment after 3 and 6 months of treatment(P<0.05);Compared with the control group,the LVEDD of the observation group after 3 and 6 months of treatment was significantly lower(P<0.05),while the IVST and LVMI of the observation group after 3 months of treatment were significantly lower(P<0.05).After 3 and 6 months of treatment,the 6MWT and LVEF of both groups increased compared to before treatment(P<0.05),and the observation group was significantly higher than that of the control group(P<0.05).The incidence of adverse cardiovascular prognosis events in the observation group was 8.77%,which was significantly lower than the 26.32%of the control group(P<0.05).Conclusion Sacubitril valsartan can effectively improve left ventricular remodeling and cardiac function in patients with AMI after emergency PCI,and reduce the incidence of cardiovascular adverse prognostic events.