沙库巴曲缬沙坦对非ST段抬高型心肌梗死伴心功能不全且行PCI术患者的疗效分析

Analysis of the Efficacy of Sakubatrovalsartan in Non-ST-Segment Elevation Myocardial Infarction Patients with Cardiac Insufficiency Undergoing PCI

摘要: 目的：本文旨在探究沙库巴曲缬沙坦(ARNI)在治疗非ST段抬高型心肌梗死(NSTEMI)伴心功能不全且行经皮冠状动脉介入治疗(PCI)术患者近期治疗的效果。方法：随机选取2018.06.01~2019.12.30青岛大学附属医院78例非ST段抬高型心肌梗死伴心功能不全且行PCI术患者，应用随机数字表法将其随机分为两组，其中观察组40例，在常规基础上应用沙库巴曲缬沙坦治疗，对照组38例，在常规基础上应用缬沙坦治疗。监测观察组及对照组血清N-末端B型利钠肽前体(NT-proBNP)以及左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)等心脏指标的变化，术后6月的临床疗效，发生药物不良反应例数以及再次住院例数。结果：a) 两组患者术后6月血NT-proBNP水平较出院前均明显下降，差异有统计学意义(P < 0.01)；且术后6月观察组血清NT-proBNP水平低于对照组(P < 0.01)。b) 两组患者术后6月LVEF、LVEDD等心脏超声指标较术前均有所改善，差异有统计学意义(P < 0.01)，观察组改善情况优于对照组(P < 0.01)。c) 出院治疗6个月后，观察组临床疗效优于对照组(P < 0.01)。结论：沙库巴曲缬沙坦应用于非ST段抬高型心肌梗死伴心功能不全且行PCI术患者中的疗效优于缬沙坦，并且可以有效逆转心室重构，改善患者的临床预后。

Abstract: Objective: In this study, we aimed to investigate the short-term efficacy of sakubatrovalsartan (ARNI) in patients, who were diagnosed for non-ST-segment elevation myocardial infarction (NSTEMI) com- plicated by cardiac insufficiency, subsequently underwent percutaneous coronary intervention (PCI). Method: A total of 78 NSTEMI patients complicated by cardiac insufficiency receiving PCI were selected in the Affiliated Hospital of Qingdao University from June 2018 to December 2019. Then they were randomly divided into the observation group (n = 40) and the control group (n = 38). In addition to conventional treatment, sakubatrovalsartan was used in the observation group, and valsartan was given in the control group. Drug efficacy and cardiac indicators including N-terminal B-type natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LVEF), left ventricular end-diastolic inner diameter (LVEDD) before operation and 6 months after operation, cases with adverse events, cases of re-hospitalization were compared between the two groups. Results: a) There were statistically significant differences in blood NT-proBNP levels before discharge and 6 months after surgery in two groups, respectively (p < 0.01). NT-proBNP in the observation group was lower than that in the control group (p < 0.01). b) Cardiac ultrasound indicators such as LVEF, LVEDD before and 6 months after surgery showed statistical improvements between the two groups (P > 0.05), respectively. The improvement of observation group was better than that of control group (p < 0.01). c) After 6 months of treatment, the clinical effect of observation group was better than that of control group (P < 0.01). Conclusion: The sakubatrovalsartan, was superior to valsartan for NSTEMI patients receiving PCI with concomitant cardiac insufficiency, which can effectively reverse ventricular remodeling and improve the clinical prognosis of patients.