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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

29卷

期数:

2023年02期

页码:

113-119

栏目:

心血管疾病专题

出版日期:

2023-03-20

文章信息/Info

Title:

Effect of sacubitril/valsartan versus ramipril on early myocardial remodeling in AMI patients undergoing PCI：a propensity matching analysis in a single center

文章编号:

1006-8147（2023）02-0113-07

作者:

叶文群¹; 2; 郭牧²; 梁海清²; 王钊²; 宋昱²

1.天津医科大学心血管病临床学院，天津300457;2.泰达国际心血管病医院心内科重症监护室，天津300457

Author(s):

YE Wen-qun¹; 2; GUO Mu²; LIANG Hai-qing²; WANG Zhao²; SONG Yu²

1.Cardiovascular Clinical Institute，Tianjin Medical University，Tianjin 300457，China;2.Cardiovascular Care Unit，TEDA International Cardiovascular Hospital，Tianjin 300457，China

关键词:

急性心肌梗死; 心室重构; 经皮冠状动脉治疗; 沙库巴曲缬沙坦; 雷米普利

Keywords:

acute myocardial infarction;  ventricular remodeling; percutaneous coronary intervetion; sacubatril/valsartan; ramipril

分类号:

R541.4

DOI:

-

文献标志码:

A

摘要:

目的：通过倾向性评分匹配法探讨沙库巴曲缬沙坦（Sacubitril/Valsartan，LCZ696）与雷米普利相比对急性心肌梗死（AMI）经皮冠状动脉治疗患者早期左室重构的影响。方法：回顾性收集2019年12月1日—2021年8月就诊泰达国际心血管病医院行经皮冠状动脉治疗的195例急性心肌梗死患者病例资料，根据出院用药分为沙库巴曲缬沙坦组（94例）和雷米普利组（101例），通过倾向性评分匹配减少药物选择偏差和混杂因素，比较两组治疗1月后心脏超声指标[左室舒张末直径（LVDd）、室间隔厚度（IVS）、左室后壁（LVPW）、左心室舒张末期容积（LVEDV）、左心室收缩末期容积（LVESV）、每搏量（SV）、左室射血分数（LVEF）]的变化。结果：匹配后，沙库巴曲缬沙坦组和雷米普利组各66例。治疗1个月后两组LVEDV[102.00（88.75，113.25）mLvs.94.00（82.75，110.50）mL，Z=-1.179，P=0.238]、LVESV[39.50（31.75，52.00）mLvs.37.00（29.75，46.00）mL，Z=-1.639，P=0.101]和LVEF[（58.77±7.66）%vs.（60.50±6.77）%，t=-1.373，P=0.172]差异均无统计学意义。两组LVEF均较治疗前升高，沙库巴曲缬沙坦组[58.00（49.00，62.25）%vs.59.00（53.75，64.25）%，Z=-3.460，P=0.001]，雷米普利组[57.50（51.75，63.50）%vs.60.00（56.00，66.00）%，Z=-3.167，P=0.002]差异有统计学意义。结论：应用沙库巴曲缬沙坦和雷米普利治疗1个月后，两组患者LVEF均较治疗前改善。但在逆转心肌梗死后早期左室重构并未发现沙库巴曲缬沙坦优于雷米普利。

Abstract:

Objective：To investigate the effect of sacubatril/valsartan（LCZ696）versus ramipril on early left ventricular remodeling（LVR） in patients with acute myocardial infarction（AMI）undergoing percutaneous coronary intervention（PCI）by propensity score matching method（PSM）. Methods ：A retrospective analysis was done on 195 patients with AMI underwent PCI in TEDA International Cardiovascular Hospital from December 1，2019 to August 2021. According to the medication，there were 94 patients in LCZ696 group and 101 patients in ramipril group. PSM was performed to minimize the impact of selection bias for the medication and confounding factors.The echocardiographic parameters[left ventricular end-diastolic diameter（LVDd），ventricular septal thickness（IVS），left ventricular posterior wall（LVPW），left ventricular end-diastolic volume（LVEDV），left ventricular end-systolic volume（LVESV），stroke volume（SV）and left ventricular ejection fraction（LVEF）]were compared. Results：After matching，there were 66 patients in each group. After one month of treatment，no significant difference in LVEDV[102.00（88.75，113.25）mL vs. 94.00（82.75，110.50）mL，Z=-1.179，P=0.238]，LVESV [39.50（31.75，52.00）mL vs. 37.00（29.75，46.00）mL，Z=-1.639，P=0.101]，and LVEF[（58.77±7.66）% vs.（60.50±6.77）%，t=-1.373， P=0.172] were found between two groups. After treatment，LVEF significantly increased in both groups. There was significant difference between sacubatril/valsartan[58.00（49.00，62.25）% vs. 59.00（53.75，64.25）%，Z=-3.460，P=0.001] and ramipril[57.50（51.75，63.50）% vs. 60.00（56.00，66.00）%，Z=-3.167，P=0.002]. Conclusion：In AMI patient undergoing PCI，one month after treatment with sacubitril/valsartan and ramipril，LVEF were improvedin both group，but sacubitril/valsartan did not have a significant reverse early remodeling effect compared with ramipril.

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备注/Memo

备注/Memo:

作者简介：叶文群（1994-），女，硕士在读，研究方向：心血管病学；
通信作者：宋昱，E-mail：dr.songyu@163.com。

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更新日期/Last Update: 2023-04-30