沙库巴曲缬沙坦对急性ST段抬高型前壁心肌梗死并心力衰竭患者心功能的影响

Effect of Sacubitril Valsartan on cardiac function in patients with acute ST-segment elevation myocardial infarction of the anterior wall complicated with heart failure

目的:探讨沙库巴曲缬沙坦在急性ST段抬高型前壁心肌梗死伴心力衰竭中的应用价值。方法:选取2017年9月至2018年11月广东省茂名市电白区人民医院收治的急性ST段抬高型前壁心肌梗死并心力衰竭患者60例作为研究对象,随机数字表法分为研究组(30例)和对照组(30例)。两组均采取PCI术,术后对照组采用常规治疗,研究组在对照组基础上加用沙库巴曲缬沙坦,治疗1个月。比较两组临床疗效、治疗前后心功能指标[左心室射血分数(LVEF)、心脏指数(CI)]及6 min步行距离(6 MWT)、醛固酮(ALD)、细胞间黏附分子-1(ICAM-1)水平。结果:研究组总有效率(93.33%)高于对照组(80.00%),但差异无统计学意义(P>0.05);疗程结束后两组LVEF、CI、6 MWT水平较治疗前增加,且研究组高于对照组(P<0.05);疗程结束后两组ALD及ICAM-1较治疗前降低,且研究组低于对照组(P<0.05)。结论:沙库巴曲缬沙坦可改善急性ST段抬高型前壁心肌梗死并心力衰竭患者PCI术后心脏功能,提高疗效。

Objective:To investigate the value of Sacubitril Valsartan in the treatment of acute ST-segment elevation myocardial infarction(STEMI)of the anterior wall complicated with heart failure.Methods:Included in this study were 60 anterior wall STEMI patients with heart failure admitted to Dianbai District People’s Hospital,Maoming of Guangdong Province,between September 2017 and November 2018,randomized into the study group and the control group(n=30 each).PCI was performed in both groups,and meanwhile the control group received routine treatment after PCI,while the study group was given Sacubitril Valsartan in addition to the routine treatment for the control group,for a duration of one month.The two groups were compared for clinical efficacy,cardiac functions[left ventricular ejection fraction(LVEF),cardiac index(CI)],6-min walk distance(6 MWT),serum aldosterone(ALD)and intercellular adhesion molecule-1(ICAM-1)levels at baseline and after treatment.Results:The total effective rate in the study group(93.33%)was higher than that in the control group(80.00%),but with no statistical difference(P>0.05).At the end of treatment,the LVEF,CI and 6 MWT were increased in the both group compared with baseline,and were even greater in the study group compared with the control group(P<0.05);the serum ALD and ICAM-1 levels in the both groups were lower than baseline,and were even lower in the study group compared with the control group(P<0.05).Conclusion:Sacubitril Valsartan may improve the post-PCI cardiac function in anterior wall STEMI patients with heart failure,with better therapeutic efficacy.