沙库巴曲缬沙坦钠片早期应用在预防急性心肌梗死患者发生心力衰竭和改善心室重塑中的价值

The Value of Early Application of Sacubitril Valsartan in Preventing Heart Failure and Improving Ventricular Remodeling in Acute Myocardial Infarction Patients

目的 研究沙库巴曲缬沙坦钠片早期应用在预防急性心肌梗死患者发生心力衰竭和改善心室重塑中的价值。方法 目的抽样法选取2023年8月-2024年1月广东省农垦中心医院心血管内科收治的80例急性心肌梗死住院患者为研究对象,按照治疗方式不同分为对照组和观察组,每组40例。分别予以缬沙坦及沙库巴曲缬沙坦钠片治疗。对比两组入院时,入院7、90 d时氮末端B型钠尿肽前体、左室收缩末期内径、左室舒张末期内径、左室射血分数、不良反应及心衰发生情况。结果 入院后7、90 d,两组患者氮末端B型钠尿肽前体水平均较入院时下降,且观察组低于对照组,差异有统计学意义(P均<0.05)。两组患者左室收缩末期内径、左室舒张末期内径随着时间延长逐渐减小,左室射血分数逐渐升高,差异有统计学意义(P均<0.05)。两组不良反应发生情况比较,差异无统计学意义(P>0.05)。观察组心力衰竭发生率为15.00%(6/40),低于对照组的35.00%(14/40),差异有统计学意义(χ^(2)=4.267,P<0.05)。结论 沙库巴曲缬沙坦钠片早期使用可减少急性心肌梗死患者心力衰竭的发生情况,改善急性心肌梗死患者的心室重塑,且临床使用安全。

Objective To study the value of early application of sacubitril valsartan sodium tablets in preventing the development of heart failure and improving ventricular remodeling in patients with acute myocardial infarction.Meth-ods eighty hospitalized patients with acute myocardial infarction admitted to the Cardiovascular Department of Guang-dong Agricultural Reclamation Center Hospital from August 2023 to January 2024 were selected as the research ob-jects by target sampling methods.They were divided into a control group and an observation group according to differ-ent treatment methods,with fourty patients in each group.The control group was treated with valsartan,while the ob-servation group was treated with sacubitril valsartan sodium tablets.Nitrogen terminal B-type natriuretic peptide pre-cursor,left ventricular end systolic diameter,left ventricular end diastolic diameter,left ventricular ejection fraction,adverse reactions,and incidence of heart failure were compared between two groups at 7 and 90 d after admission.Re-sults 7 d and 90 d after admission,the levels of N-terminal B-type natriuretic peptide precursor in both groups of pa-tients decreased compared to admission,and the observation group was lower than the control group,the differences were statistically significant(all P<0.05).The left ventricular end systolic diameter and left ventricular end diastolic diameter gradually decreased over time between the two groups of patients,and the left ventricular ejection fraction gradually increased,the differences were statistically significant(all P<0.05).There was no statistically significant dif-ference in the occurrence of adverse reactions between the two groups(P>0.05).The incidence of heart failure in the observation group was 15.00%(6/40),which was lower than 35.00%(14/40)in the control group,and the difference was statistically significant(χ^(2)=4.267,P<0.05).Conclusion Early use of sacubitril valsartan sodium tablets can re-duce the incidence of heart failure in patients with acute myocardial infarction,improve ventricular remodeling in pa-tients with acute myocardial infarction,and is safe for clinical use.