| 龚中元,张银妆,方 立,沈智洁,袁 渊.钠-葡萄糖协同转运蛋白-2抑制剂联合沙库巴曲缬沙坦钠治疗射血分数降低的心力衰竭患者的临床研究[J].,2023,(7):1299-1303 |
| 钠-葡萄糖协同转运蛋白-2抑制剂联合沙库巴曲缬沙坦钠治疗射血分数降低的心力衰竭患者的临床研究 |
| Clinical Study on the Treatment of Heart Failure with Reduced Ejection Fraction by Sodium Glucose Cotransporter-2 Inhibitor Combined with Sarcubatrix Valsartan Sodium |
| 投稿时间：2022-10-26 修订日期：2022-11-22 |
| DOI：10.13241/j.cnki.pmb.2023.07.019 |
| 中文关键词: 射血分数降低的心力衰竭 SGLT-2抑制剂 达格列净 沙库巴曲缬沙坦钠 心功能 炎性因子 生活质量 安全性 |
| 英文关键词: Heart failure with reduced ejection fraction SGLT-2 inhibitor Dagglizin Sarcubatrix valsartan sodium Cardiac function Inflammatory factors Quality of life Security |
| 基金项目:湖南省自然科学基金项目（2022JJ40517） |
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| 中文摘要: |
| 摘要 目的：探讨钠-葡萄糖协同转运蛋白-2（SGLT-2）抑制剂达格列净联合沙库巴曲缬沙坦钠治疗射血分数降低的心力衰竭（HFrEF）患者的临床疗效，以期为HFrEF患者的治疗提供合理有效治疗方案。方法：选取2020年11月-2022年4月于长沙市第一医院心血管内科就诊的100例HFrEF患者为研究对象，每位患者随机赋予1个数字，获得100个随机号，按照数字奇偶法随机分为对照组和观察组各50例。其中对照组给予HFrEF标准药物治疗，观察组于对照组基础上给予SGLT-2抑制剂达格列净联合沙库巴曲缬沙坦钠治疗，两组均治疗6个月。比较两组临床疗效、治疗前及治疗6个月后心功能指标[左心室射血分数（LVEF）、左室舒张末期内径（LVEDD）、心输出量（CO）、6 min步行距离（6MWD）]、血清学指标[N末端前体脑利钠肽（NT-proBNP）、白细胞介素（IL-1β）、白细胞介素-6（IL-6）、肿瘤坏死因子-α(TNF-α)]水平、明尼苏达心力衰竭生活质量量表（MLHFQ）评分及治疗期间因心衰再住院、室性心律失常及MACE事件发生情况。结果：两组临床疗效分级经Ridit分析u检验显示差异有统计学意义（P＜0.05）；观察组总有效率94.00%高于对照组80.00%（P＜0.05）。治疗6个月后,观察组LVEF、CO、6MWD高于对照组，LVEDD、NT-proBNP、IL-1β、IL-6、TNF-α、MLHFQ评分低于对照组（P＜0.05）。观察组治疗期间因心衰再住院发生率、MACE事件发生率均低于对照组（P＜0.05）。结论：SGLT-2抑制剂达格列净联合沙库巴曲缬沙坦钠治疗HFrEF患者可明显改善患者心功能、机体炎性反应及生活质量，临床疗效和预后均明显优势，是治疗HFrEF患者的合理有效治疗方案，值得临床借鉴应用。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the clinical efficacy of sodium glucose cotransporter-2 (SGLT-2) inhibitor Dagglizin combined with sarcubatrix valsartan sodium in the treatment of patients with heart failure with reduced ejection fraction (HFrEF), in order to provide a reasonable and effective treatment plan for the treatment of HFrEF patients. Methods: 100 patients with HFrEF who were treated in the Cardiology Department of Changsha First Hospital from November 2020 to April 2022 were selected as the study subjects. Each patient was randomly assigned a number, and 100 random numbers were obtained. They were randomly divided into control group and observation group according to the number parity method with 50 patients in each group. The control group was treated with HFrEF standard drug, and the observation group was treated with SGLT-2 inhibitor Dagglizin combined with sarcubatrix valsartan sodium on the basis of the control group. Both groups were treated for 6 months. Compare the clinical efficacy, cardiac function indexes [left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), cardiac output (CO), 6-minute walking distance (6MWD)],serological indexes[N-terminal pro-brain natriuretic peptide (NT-proBNP), interleukin-1β(IL-1β), Interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α)] Level, the score of Minnesota Heart Failure Quality of Life Scale(MLHFQ) and the heart failure rehospitalization, ventricular arrhythmia and MACE events during treatment. Results: The clinical efficacy grading of the two groups was statistically significant by Ridit analysis u test(P<0.05). The total effective rate of the observation group was 94.00% higher than that of the control group 80.00%(P<0.05). After 6 months of treatment, LVEF, CO and 6 MWD in the observation group were higher than those in the control group, LVEDD, NT-proBNP, IL-1β, IL-6, TNF-α and MLHFQ scores were lower than those in the control group(P<0.05). The incidence of heart failure rehospitalization and MACE events during treatment in the observation group were lower than those in the control group (P<0.05). Conclusion: SGLT-2 inhibitor Dagglizin combined with sarcubatrix valsartan sodium in the treatment of patients with HFrEF can significantly improve the cardiac function, inflammatory reaction and quality of life of patients with HFrEF, and has obvious advantages in clinical efficacy and prognosis. It is a reasonable and effective treatment plan for patients with HFrEF, which is worthy of clinical reference and application. |
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