摘要
目的研究沙库巴曲缬沙坦钠在心肌梗死后心力衰竭患者中的应用效果。方法选取2020年11月至2022年11月驻马店市中心医院收治的211例心肌梗死后慢性心力衰竭患者,以随机数字表法分为联合组(105例)和对照组(106例)。对照组接受硝酸异山梨酯类药物、利尿剂以及琥珀酸美托洛尔等治疗,联合组在对照组基础上接受沙库巴曲缬沙坦钠治疗。比较两组临床疗效,治疗前后心功能指标[左心射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、每搏输出量(SV)]、心室重塑指标[室间隔厚度(IVST)、左室质量指数(LNMI)]、外周血生化指标[血管内皮生长因子(VEGF)和脂质运载蛋白2(LCN2)]及不良反应情况。结果治疗后联合组临床疗效、LVEF和SV高于对照组,LVESD和LVEDD低于对照组(P<0.05)。联合组IVST、LNMI、LCN2水平低于对照组,VEGF水平高于对照组(P<0.05),不良反应的总发生率低于对照组(P<0.05)。结论沙库巴曲缬沙坦钠联合琥珀酸美托洛尔治疗心肌梗死后慢性心力衰竭效果确切,在改善患者心功能指标与心室重塑的同时可上调外周血清VEGF的水平并抑制血清LCN2的表达,且能减少不良反应的发生。
Objective To study the application effect of sacubitril valsartan sodium in patients with heart failure after myocardial infarction.Methods A total of 211 patients with chronic heart failure after myocardial infarction admitted to Zhumadian Central Hospital from November 2020 to November 2022 were randomly divided into combination group(105 cases)and control group(106 cases)using a random number table method.The control group received treatment with isosorbide dinitrate lipid drugs,diuretics,and metoprolol succinate,while the combined group received treatment with sacubitril valsartan sodium on the basis of the control group.Clinical efficacy,cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD)and stroke volume(SV)],ventricular remodeling indexes[interventricular septal thickness(IVST)and left ventricular mass index(LNMI)]and peripheral blood biochemical indexes[vascular endothelial growth factor(VEGF),lipocalin-2(LCN2)],and adverse reactions were compared between the two groups.Results After treatment,the clinical efficacy,LVEF and SV of the combination group were higher than those of the control group,while LVESD and LVEDD were lower than those of the control group(P<0.05).The levels of IVST,LNMI,and LCN2 in the combination group were lower than those in the control group,while the levels of VEGF were higher than those in the control group(P<0.05),and the overall incidence of adverse reactions was lower than that in the control group(P<0.05).Conclusion The combination of sacubitril valsartan sodium and metoprolol succinate has a definite effect on the treatment of chronic heart failure after myocardial infarction.While improving cardiac function indicators and ventricular remodeling in patients,it can upregulate the level of peripheral serum VEGF and inhibit the expression of serum LCN2,and reduce the occurrence of adverse reactions.
作者
张月婷
关玲霞
郁冲
刘新锋
马新豫
刘豪
ZHANG Yueting;GUAN Lingxia;YU Chong;LIU Xinfeng;MA Xinyu;LIU Hao(The First Ward of Cardiovascular,Zhumadian Central Hospital,Zhumadian 463000,China)
出处
《河南医学研究》
CAS
2023年第13期2438-2442,共5页
Henan Medical Research
关键词
沙库巴曲缬沙坦钠
美托洛尔
心肌梗死
心功能
心室重塑
血管内皮生长因子
脂质运载蛋白2
sacubitril valsartan sodium
metoprolol
myocardial infarction
cardiac function
ventricular remodeling
vascular endothelial growth factor
lipocalin-2
