沙库巴曲缬沙坦钠治疗老年急性心肌梗死合并心力衰竭的效果及安全性

Efficacy and safety of sacubitril valsartan sodium in the treatment of elderly patients with acute myocardial infarction complicated with heart failure

目的 观察沙库巴曲缬沙坦钠治疗老年急性心肌梗死合并心力衰竭的效果及安全性。方法 选取2020年1月—2022年12月漳州市医院收治的老年急性心肌梗死合并心力衰竭患者156例,将2020年1月—2021年6月收治的78例纳入常规组,2021年7月—2022年12月收治的78例纳入诺欣妥组。常规组采用常规强心利尿治疗,诺欣妥组在常规强心利尿治疗基础上联合沙库巴曲缬沙坦钠治疗,治疗3个月后比较2组疗效,治疗前后心功能[左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)]及不良反应。结果 诺欣妥组总有效率为96.15%,高于常规组的85.90%(χ^(2)=5.022,P=0.025);治疗3个月后,2组LVEDD、LVESD均缩小,且诺欣妥组小于常规组(P<0.01);诺欣妥组与常规组不良反应总发生率比较无明显差异(3.85%vs.6.41%,χ^(2)=0.132,P=0.717)。结论 沙库巴曲缬沙坦钠治疗老年急性心肌梗死合并心力衰竭,既能有效提高治疗效果,又能改善心功能,且安全性高。

Objective To observe the efficacy and safety of sacubitril valsartan sodium in the treatment of elderly patients with acute myocardial infarction complicated with heart failure.Methods A total of 156 elderly patients with acute myocardial infarction complicated with heart failure admitted to Zhangzhou Municipal Hospital of Fujian Province from January 2020 to December 2022 were selected.The 78 cases admitted from January 2020 to June 2021 were included in the routine group,and 78 cases admitted from July 2021 to December 2022 were included in the entresto group.The routine group was treated with conventional cardiac diuresis,and the entresto group was treated with sacubitril valsartan sodium on the basis of conventional cardiac diuresis.After 3 months of treatment,the treatment effect,and the cardiac function[left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)] before and after treatment,and adverse reactions of the two groups were compared.Results The total effective rate of entresto group was 96.15%,which was higher than 85.90% in routine group(χ^(2)=5.022,P=0.025).After 3 months of treatment,LVEDD and LVESD were reduced in two groups,and entresto group showing smaller values than routine group(P<0.01).There was no significant difference in the overall incidence of adverse reactions between the entresto group and the routine group(3.85% vs.6.41%,χ^(2)=0.132,P=0.717).Conclusion Sacubitril valsartan sodium in the treatment of acute myocardial infarction complicated with heart failure in the elderly can not only effectively improve the therapeutic effect,but also improve the cardiac function,and high safety.