| 钱倩倩,程自平,吴敏,陈晨,杨辉.冠心病伴高血压患者经皮冠状动脉介入治疗术后服用沙库巴曲缬沙坦钠的临床疗效[J].中国临床保健杂志,2023,26(4):550-555. |
| 冠心病伴高血压患者经皮冠状动脉介入治疗术后服用沙库巴曲缬沙坦钠的临床疗效 |
| Clinical effect of sacubitril valsartan sodium in patients with coronary heart disease and hypertension after PCI |
| 投稿时间：2023-06-01 |
| DOI：10.3969/J.issn.1672-6790.2023.04.026 |
| 中文关键词: 高血压 冠心病 经皮冠状动脉介入治疗 手术后医护 心血管疾病 |
| 英文关键词: Hypertension Coronary disease Percutaneous coronary intervention Postoperative care Cardiovascular diseases 〖FL |
| 基金项目:安徽省卫生健康委科研项目(AHWJ2022b043)；安徽医科大学第四附属医院科研培育基金项目(2022YKJ14) |
| 作者 | 单位 | E-mail | | 钱倩倩 | 安徽医科大学第一附属医院 安徽省公共卫生中心,心血管内科,合肥 230022 | angie_qian@163.com | | 程自平 | 安徽医科大学第一附属医院 安徽省公共卫生中心,心血管内科,合肥 230022 | | | 吴敏 | 安徽医科大学第一附属医院 安徽省公共卫生中心,呼吸与危重症医学科,合肥 230022 | | | 陈晨 | 安徽医科大学第一附属医院 安徽省公共卫生中心,心血管内科,合肥 230022 | | | 杨辉 | 安徽医科大学第一附属医院 安徽省公共卫生中心,心血管内科,合肥 230022 | |
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| 中文摘要: |
| 目的 观察冠心病伴高血压患者经皮冠状动脉介入治疗(PCI)术后服用沙库巴曲缬沙坦钠的临床疗效。方法 回顾性分析2020年7月至2022年11月在安徽医科大学第一附属医院住院的94例冠心病伴高血压行PCI术患者病历资料,按随机数字分组法分为2组,按纳排标准,最终对照组43例和观察组51例。2组冠心病患者均接受二级预防常规药物治疗,此外,对照组和观察组分别口服贝那普利和沙库巴曲缬沙坦钠。2组所有患者均接受6个月的连续服药治疗,并完成治疗后30 d及6个月的随访。比较治疗前后2组患者左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、血浆N末端B型脑钠肽前体(NT-proBNP)、收缩压(SBP)、舒张压(DBP)、估算肾小球滤过率(eGFR)和不良反应,以及再次心肌梗死、心力衰竭住院和病死率。结果 治疗后6个月时,观察组LVEDD与对照组较治疗前均显著减少(P<0.05),2组间差异无统计学意义(P>0.05)；而观察组LVEF(54.96%±7.34%)比对照组(52.91%±4.17%)显著提高,差异有统计学意义(P<0.05)。治疗后,2组NT-proBNP浓度均较治疗前水平大幅下降,在治疗30 d时观察组(315.92 ng/L)较对照组(672.65 ng/L)明显降低(P<0.05),且持续至治疗后6个月(312.71 ng/L比519.70 ng/L,P<0.05)。观察组的SPB[(107.24±4.08)mmHg](1 mmHg=0.133 kPa)较对照组[(112.12±5.97)mmHg]在30 d时有明显下降(P<0.05),且持续至6个月[(107.98±4.254)mmHg比(112.07±5.69)mmHg],差异有统计学意义(P＜0.05)。观察组的DPB[(66.31±3.50)mmHg]较对照组[(70.37±4.76)mmHg]在30 d时有明显下降(P<0.05),且持续至6个月[(66.04±3.67)mmHg比(69.51±4.14)mmHg],差异有统计学意义(P<0.05)。治疗前后2组eGFR差异无统计学意义(P>0.05)。治疗期间观察组因心力衰竭再住院率低于对照组[15.69%(8/51)比37.21%(16/43)],差异有统计学意义(P<0.05)。2组再次心肌梗死率比较,差异无统计学意义(P>0.05)。2组均未观察到不良安全事件(低血压、高钾血症、肾功能恶化或血管性水肿)。结论 与贝那普利相比较,冠心病伴高血压患者PCI术后早期使用沙库巴曲缬沙坦钠能明显改善左心室收缩功能,降低心血管不良事件的发生率及心衰再住院率。 |
| 英文摘要: |
| Objective To observe the clinical effect of sacubitril valsartan sodium in patients with coronary heart disease and hypertension after percutaneous coronary intervention(PCI).Methods From July 2020 to November 2022,a total of 94 patients with coronary heart disease and hypertension undergoing percutaneous coronary intervention (PCI) from the First Affiliated Hospital of Anhui Medical University were selected,method patients were divided into observation group (n=51) and control group (n=43) by useing random number grouping.All patients in both groups were treated secondary prevention of drug treatment for coronary atherosclerotic heart disease.On this basis,the control group was given benazepril orally,and the observation group was given sacubitril /valsartan sodium orally.All patients in both groups were treated continuously for 6 months with follow-up visits at 30 days and 6 months.The left ventricular end-diastolic diameter (LVEDD),left ventricular ejection fraction (LVEF),plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP),systolic blood pressure (SBP),diastolic blood pressure (DBP),estimated glomerular filtration rate (eGFR) and adverse reactions,and remyocardial infarction,hospitalizations for heart failure,and mortality were compared between the two groups before and after treatment.Results At the 6th months after treatment,LVEDD in the observation group was significantly lower than that in the control group (P<0.05),and there was no significant difference between the two groups (P>0.05).The LVEF in the observation group (54.96%±7.34%) was significantly higher than that in the control group (52.91%±4.17%),P<0.05.After treatment,the levels of NT-proBNP in the two groups were significantly lower than those before treatment.At the 30th day after treatment,the concentration of NT-probnp in the observation group (315.92 ng/L) was significantly lower than that in the control group (672.65 ng/L),P<0.05.And continued to 6 months after treatment (312.71 ng/L vs.519.70ng/L,P<0.05).The SPB of the observation group [(107.24±4.08)mmHg](1 mmHg=0.133 kPa) was significantly lower than that of the control group [(112.12±5.97)mmHg] at 30 days (P<0.05),and continued to 6 months[(107.98±4.254)mmHg vs.(112.07±5.69)mmHg,P<0.05].It was statistically significant.The DPB of the observation group [(66.31±3.50)mmHg] was significantly lower than that of the control group [(70.37±4.76)mmHg] at 30 days (P<0.05),and lasted to 6 months [(66.04±3.67)mmHg vs.(69.51±4.14)mmHg,P<0.05].It was statistically significant.There was no significant difference in eGFR between the two groups before and after treatment (P>0.05).During the treatment,the rehospitalization rate due to heart failure in the observation group was lower than that in the control group:15.69% (8/51) vs.37.21% (16/43),and the difference was statistically significant (P<0.05).There was no significant difference in the rate of re-myocardial infarction between the two groups (P>0.05).No adverse safety events (hypotension,hyperkalemia,worsening renal function,or angioedema) were observed in either group.Conclusions Compared with benazepril,early use of sacubitril valsartan sodium after PCI for coronary heart disease with hypertension can significantly improve left ventricular systolic function,reduce the incidence of MACE and rate of re-hospitalization. |
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