摘要
目的:探究沙库巴曲缬沙坦钠对缺血性心肌病型(ICM)冠心病患者血管内皮功能、心室重构、心功能及生活质量的影响。方法:选取180例ICM冠心病患者,随机分为对照组(n=90)与观察组(n=90)。两组患者入院后接受常规基础治疗,观察组口服沙库巴曲缬沙坦钠,治疗12周。比较两组治疗前后心室重构指标[左心室质量指数(LVMI)、左心室后壁厚度(LVPWT)、室间隔厚度(IVST)],血管内皮功能指标[内皮素-1(ET-1)、一氧化氮(NO)、血管紧张素Ⅱ(AngⅡ)、血管内皮生长因子(VEGF)],心功能指标[N末端钠尿肽前体(NT-proBNP)、肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)],心功能分级及明尼苏达生活质量问卷(MLHFQ)评分。结果:治疗后,心室重构指标:观察组LVMI、LVPWT、IVST较对照组显著降低(均P<0.05);血管内皮功能:观察组NO水平高于对照组,ET-1、VEGF、AngⅡ显著低于对照组(均P<0.05);心功能指标:观察组NT-pro BNP、cTnI、CK-MB水平显著低于对照组(均P<0.05);观察组总有效率高于对照组(χ^(2)=5.000,P=0.025);两组不良反应发生率比较无统计学差异(χ^(2)=1.497,P=0.221)。结论:沙库巴曲缬沙坦钠能有效抑制ICM冠心病患者的心室重构、保护其血管内皮功能及心功能,使得患者生活质量得以提高,且用药安全性得以保证。
Objective:To investigate the effect of sacubitril/valsartan sodium on vascular endothelial function,ventricular remodeling,cardiac function and quality of life in patients with ischemic cardiomyopathy(ICM).Methods:A total of 180 ICM patients were randomly divided into a control group(n=90,treated with enalapril)and an observation group(n=90,treated with Sac/Val).Both groups received conventional therapy,and the observation group was orally administered Sac/Val for 12 weeks.Ventricular remodeling indices LVMI,LVPWT,IVST,Vascular endothelial function indexes:vascular endothelial growth factor(VEGF),angiotensinⅡ(AngⅡ);Cardiac function indexes:N-terminal pro natriuretic peptide(NT Pro BNP),cardiac troponin I(cTnI)and creatine kinase isoenzyme(CK-MB);Cardiac function classification;and MLHFQ scores were compared.Results:After treatment,the observation group showed significantly lower LVMI,LVPWT,and IVST compared to the control group(all P<0.05).Vascular endothelial function improved more prominently in the observation group,with higher NO levels and significantly reduced ET-1,VEGF,and AngⅡlevels(all P<0.05).Cardiac function biomarkers(NT-proBNP,cTnI,CK-MB)were significantly lower in the observation group(all P<0.05).The total effective rate was higher in the observation group(χ^(2)=5.000,P=0.025),with no meaningful difference in the incidence of adverse reactions with each other(χ^(2)=1.497,P=0.221).Conclusion:Sacubitril-valsartan sodium can effectively inhibit ventricular remodeling,protect vascular endothelial function and cardiac function in patients with ICM coronary heart disease,improve the quality of life of patients,and ensure the safety of medication.
作者
文倩
何嘉俊
刘伟涛
陈雪营
WEN Qian;HE Jiajun;LIU Weitao;CHEN Xueying(Department of Cardiology,Baiyun Branch,Nanfang Hospital,Southern Medical University,Guangzhou 510000,China)
出处
《陕西医学杂志》
2025年第4期529-533,共5页
Shaanxi Medical Journal
基金
广东省卫生健康委员会科研项目(2021XT-661)。
关键词
缺血性心肌病型冠心病
沙库巴曲缬沙坦钠
血管内皮功能
心室重构
心功能
生活质量
Ischemic cardiomyopathy coronary heart disease
Sacubitril/valsartan sodium
Vascular endothelial function
Ventricular remodeling
Cardiac function
Quality of life
