| 沈国秀,王贤进,顾崇怀,项学军.沙库巴曲缬沙坦治疗急性心肌梗死合并Ⅱ~Ⅲ期慢性肾脏病患者的短期效果[J].中国临床保健杂志,2022,25(3):363-367. |
| 沙库巴曲缬沙坦治疗急性心肌梗死合并Ⅱ~Ⅲ期慢性肾脏病患者的短期效果 |
| Short-term efficacy and safety of sacubitril/valsartan in patients with acute myocardial infarction complicated with stage Ⅱ-Ⅲ chronic kidney disease |
| 投稿时间：2022-04-27 |
| DOI：10.3969/J.issn.1672-6790.2022.03.017 |
| 中文关键词: 心肌梗死 沙库巴曲缬沙坦 肾功能不全 |
| 英文关键词: Myocardial infarction Acubitril/Valsartan Renal insufficiency 〖FL |
| 基金项目:安徽省安庆市科技局基金项目(2021Z2001) |
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| 中文摘要: |
| 目的 探讨沙库巴曲缬沙坦治疗急性心肌梗死合并Ⅱ~Ⅲ期慢性肾脏病患者住院期间的治疗效果。方法 回顾性分析2019年1月1日至2022年3月31日于安庆市立医院住院的急性心肌梗死合并Ⅱ~Ⅲ期慢性肾脏病患者病历资料,依据其使用不同种类肾素-血管紧张素-醛固酮系统(RAAS)抑制剂将其分组为沙库巴曲缬沙坦组96例,缬沙坦组126例,共计222例患者。分别记录入院及出院时估算的肾小球滤过率(eGFR)、左室射血分数(LVEF),疗效值及安全效应值分别为出院LVEF、eGFR水平与入院时比较的差值,同时使用1∶1倾向性评分匹配(PSM)比较均衡基线资料后效应量的改变。结果 2组出院LVEF、eGFR较入院时均有改善,差异有统计学意义(P＜0.05),组间比较显示沙库巴曲缬沙坦组出院LVEF、eGFR改善程度更大,差异有统计学意义(P＜0.05)；在进行PSM均衡基线后(匹配后2组各70例),沙库巴曲缬沙坦组出院LVEF、eGFR较入院时仍有改善,差异有统计学意义(P＜0.05)；缬沙坦组出院LVEF较入院时有改善,差异有统计学意义(P＜0.05),eGFR水平出院与入院比较,差异无统计学意义(P＞0.05)；PSM后LVEF改善程度2组比较,差异无统计学意义(P＞0.05)。结论 沙库巴曲缬沙坦能够改善急性心肌梗死合并Ⅱ~Ⅲ期慢性肾脏病患者住院期间心、肾功能,使用安全有效。 |
| 英文摘要: |
| Objective To evaluate the efficacy and safety of sacubitril/valsartan (sac/val) in patients with acute myocardial infarction complicated with mild to moderate renal insufficiency.Methods The medical records of patients with acute myocardial infarction complicated with stage Ⅱ-Ⅲ chronic kidney disease hospitalized in Anqing Municipal Hospital from January 1,2019 to March 31,2022 were selected,according to their use of different types of renin-angiotensin-aldosterone system (RAAS) inhibitors,they were divided into sac/val group (96 patients) and valsartan group (126 patients) in a total of 222 patients.Glomerular filtration rate (eGFR) and left ventricular ejection fraction (LVEF) at admission and discharge were recorded respectively.The efficacy effect value and safety effect value were the difference of LVEF and eGFR levels at discharge compared with those at admission,respectively.The 1∶1 propensity score matching (PSM) was used to compare changes in effect size after equalizing baseline data.Results LVEF and eGFR levels at discharge were improved in both groups compared with those at admission (P<0.05),the improvement of LVEF and eGFR levels in the sac/val group was greater than that in the valsartan group (P<0.05).After baseline data were balanced by PSM(there were 70 patients in each group),the levels of LVEF and eGFR in sac/val group at discharge were still improved compared with those at admission (P<0.05).In the valsartan group,the level of LVEF at discharge was improved compared with that at admission(P<0.05),but the level of eGFR was not significantly improved(P＞0.05).There was no statistical difference in the improvement degree of LVEF level between the two groups(P＞0.05).Conclusions The use of sac/val is safe and effective in patients with acute myocardial infarction complicated with stage Ⅱ-Ⅲ chronic kidney disease during hospitalization. |
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