沙库巴曲缬沙坦钠对急性心肌梗死后心力衰竭患者血清sFRP5、VS-2、GRK2水平的影响

Effect of Sacubitril and Valsartan Sodium on Serum sFRP5,VS⁃2,and GRK2 Levels in Patients with Heart Failure After Acute Myocardial Infarction

目的 探讨沙库巴曲缬沙坦钠对急性心肌梗死(AMI)后心力衰竭患者血清分泌型卷曲相关蛋白5(sFRP5)、血管抑制因子-2(VS-2)、G蛋白耦联受体激酶2(GRK2)水平的影响。方法 以随机数表法将江西省丰城市人民医院收治的108例AMI后心力衰竭患者分为A组及B组,各54例。B组采用常规治疗方法,A组在此基础上增加沙库巴曲缬沙坦钠治疗,比较两组血清sFRP5、VS-2、GRK2水平、心室重构及心功能指标、临床症状及生活质量、不良反应。结果 治疗后A组左心室舒张末期室间隔厚度(IVST)、左心室舒张末期内径(LVEDd)、左心室收缩末期后壁厚度(LVPWT)、左心室收缩末期内径(LVESd)、左心室质量指数(LVMI)低于B组,心排血指数(CI)高于B组(P<0.05);治疗后A组sFRP5、VS-2水平高于B组,GRK2水平低于B组(P<0.05);治疗后A组Lee氏心力衰竭积分、心功能不全生活质量量表(MLHFQ)评分低于B组(P<0.05);A、B组总不良反应发生率比较差异无统计学意义(P>0.05)。结论 沙库巴曲缬沙坦钠可以提高AMI后心力衰竭患者心功能,改善心肌重构,提高血清sFRP5、VS-2水平,降低GRK2表达,改善患者临床症状。

OBJECTIVE To investigate the effects of sakubatrotril valsartan sodium on serum secretory frizzle⁃associated protein 5(sFRP5),vasostatin 2(VS⁃2)and G protein coupled receptor kinase 2(GRK2)levels in patients with heart failure after acute myocardial infarction(AMI).METHODS A total of 108 patients with heart failure after AMI admitted to Fengcheng People's Hospital in Jiangxi Province were divided into Group A and Group B using a random number table method,with 54 cases in each group.Group B received conventional treatment,while Group A received additional treatment with sacubitril and valsartan sodium.The serum sFRP5,VS⁃2,GRK2 levels,ventricular remodeling and heart function indicators,clinical symptoms,quality of life,and adverse reactions were compared between the two groups.RESULTS After treatment,left ventricular end⁃diastolic septal thickness(IVST),left ventricular end⁃diastolic diameter(LVEDd),left ventricular end⁃systolic posterior wall thickness(LVPWT),left ventricular end⁃systolic diameter(LVESd)and left ventricular mass index(LVMI)in group A were lower than those in group B,and cardiac output index(CI)was higher than those in group B(P<0.05).After treatment,sFRP5 and VS⁃2 levels in group A were higher than those in group B,and GRK2 levels were lower than those in group B(P<0.05).After treatment,the levels of sFRP5 and VS⁃2 in Group A were higher than those in Group B,while the levels of GRK2 were lower than those in Group B(P<0.05).After treatment,the Lee's heart failure score and cardiac dysfunction quality of life questionnaire(MLHFQ)score in Group A were lower than those in Group B(P<0.05).There was no statistically significant difference in the overall incidence of adverse reactions between Group A and Group B(P>0.05).CONCLUSION Sacubitril valsartan sodium can improve heart function,myocardial remodeling,serum sFRP5 and VS⁃2 levels,reduce GRK2 expression,and improve clinical symptoms in patients with heart failure after AMI.