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北京京煤集团总医院                                                          第十一届·2023 学术年会论文集

                       沙库巴曲缬沙坦对急性 ST 段抬高型心肌梗死 PCI 术后


                                            心功能影响的临床观察


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                                       李慧君 ,李思 ,白旭鹏 ,李利军 ,石红坡
                              (1.  北京京煤集团总医院心内科;北京市丰台区中医医院心内科)
                   通信作者:石红坡,E-mail:shihongpo1990@163.com
                   【摘要】目的:探讨沙库巴曲缬沙坦(sacubitril/valsartan,SacNal)对急性 ST 段抬高型心肌梗
                   死(ST-segmentelevation myocardial infarction,STEMI)PCI 术后心功能的影响。方法:选取 2021

                   年 8-12 月北京京煤集团总医院心内科的 52 例 STEMI 住院患者,经皮冠状动脉介
                   A(pereutaneous coronary intervention,PCI)术后,将患者随机分为观察组和对照组,每组 26

                   例,观察组在常规治疗基础上给予 Sac/Val,对照组在常规治疗基础上给予血管紧张素转化
                   酶抑制剂(angiotensin convening enzyme inhibitor,ACEI)或血管紧张素受体拮抗剂(angiotensin

                   receptor blocker,ARB),两组均维持用药 3 个月,比较两组治疗前和治疗后 3 个月心功能。
                   结果:52 例患者中,男 35 例,女 17 例,年龄 22~86 岁,平均(61.8±13.7)岁。两组治疗前

                   静息 HR、QTc 间期、N 末端脑钠肽前体(N-terminalbrain natriureticpeptideprecursor。NT-

                   proBNP)、左室射血分数(1eft ventricular ejection fraction,LVEF)及左室舒张末期内径(1eft
                   ventricular diastolic diameter,LVEDD)和治疗后静息 HR、QTc 间期、LVEDD 及不良反应发

                   生率的比较,差异均无统计学意义(P>0.05)。治疗后,观察组 NT-proBNP 和不良心血管事件
                   (major adverse cardiac events,MACE)发生率低于对照组[302.50(181.50,637.00)pg/mL 比

                   739.00(256.25,1 674.00)pg/mL,11.54%比 38.46%],LVEF 高于对照组[60.00(52.00,61.25)%
                   比 54.50(47.00,60.00)%],差异均有统计学意义(P<0.05)。结论:与传统 ACEI 或 ARB 治疗

                   相比,Sac/Val 在 STEMI 患者 PCI 术后短期内心功能疗效更佳,减少 MACE 发生,且未增

                   加相关不良反应。
                   【关键词】沙库巴曲缬沙坦;急性 ST 段抬高型心肌梗死;心功能
                       Clinical observation of saeubitril/valsartan on cardiac function in acute ST-segment

                                          elevation myocardial infarction after PCI
                   [Abstract] Objective To explore the effect of sacubitril/valsartan(Sac/Val) on cardiac function in
                   acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 52 STEMI patients

                   admitted to the Department of Cardiology, Beijing Jingmei Group General Hospital from August to
                   December 2021 were selected.All patients were randomly divided into observation group and

                   control group after percutaneous coronary intervention(PCI),with 26 cases in each group.The
                   observation group was given Sac/Val while the control group Was given angiotensin converting
                   enzyme inhibitor(ACEI) or angiotensin receptor blocker(ARB) on the basis of routine treatment for

                   3  months.  The  cardiac  function  of  the  two  groups  were  compared  before  and  3  months  after
                   treatment. Results Among the 52 patients,there were 35 males and 17 females, aged from 22 to


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