达格列净联合诺欣妥对急性心肌梗死患者急诊介入治疗后心力衰竭的疗效  

Effect of combination therapy with Dapagliflozin and Entresto on heart failure after emergency intervention in patients with acute myocardial infarction

作　　者：盛雪 纪征[2] 王兆翔[2] 马辰星 SHENG Xue;JI Zheng;WANG Zhaoxiang;MA Chenxing(Department of North China University of Science and Technology,Tangshan 063000,China)

机构地区：[1]华北理工大学研究生学院,河北唐山063000 [2]唐山市工人医院心内一科,河北唐山063000 [3]唐山中心医院内分泌科,河北唐山063000

出　　处：《实用医学杂志》2022年第11期1410-1414,共5页The Journal of Practical Medicine

基　　金：河北省卫生健康委员会科研基金项目(编号:20221778)。

摘　　要：目的 达格列净联合诺欣妥对急性心肌梗死(AMI)患者急诊介入治疗后心力衰竭(HF)的疗效。方法 入选AMI急诊行经皮冠状动脉介入治疗(PCI)后出现HF患者120例,按就诊顺序将患者随机分为研究组和对照组各60例。对照组在标准治疗基础上加用诺欣妥,研究组在对照组基础上加用达格列净。治疗6个月,采用时间分辨免疫荧光法检测NT-proBNP、上转发光法检测Lp-PLA2,并记录患者收缩末期左室内径(LVESD)、舒张末期左室内径(LVEDD)、舒张末期左室容积(LVEDV)、射血分数(LVEF)、左室质量指数(LVMI)、左室重构指数(LVRI)、6 min步行试验(6MWT)及治疗随访期间主要心血管不良事件(MACE)和不良反应情况。结果 治疗后,两组的NT-proBNP、Lp-PLA2均较治疗前降低(P <0.05),且研究组较对照组下降明显(P <0.05)。两组的LVESD、LVEDD、LVEDV、LVMI、LVRI均较治疗前降低(P <0.05),LVEF较治疗前增加(P <0.05);且研究组LVESD、LVEDD、LVEDV、LVMI、LVRI较对照组降低明显(P <0.05),研究组LVEF较对照组升高明显(P <0.05)。治疗3、6个月时,两组患者6MWT水平较治疗1个月时明显增加(P <0.05);治疗6个月时,两组患者6MWT水平较治疗3个月时明显增加(P <0.05)。且研究组增高程度明显高于同时间对照组,差异存在统计学意义(P <0.05)。与对照组相比,研究组MACE发生率明显较低(P <0.05);不良反应发生率稍高,但差异无统计学意义(P> 0.05)。结论 达格列净联合诺欣妥治疗AMI急诊PCI后心力衰竭患者的疗效优于诺欣妥治疗,可降低Lp-PLA2,改善心功能和左室重构,降低MACE发生率,并且安全性良好。Objective To evaluate the effect of Dapagliflozin combined with Entresto on heart failure after emergency intervention in patients with acute myocardial infarction(AMI). Methods A total of 120 patients with heart failure after an AMI who presented to the emergency department for percutaneous coronary intervention were enrolled and randomly assigned to the control or study groups. The control group was treated with standard therapy based on the addition of Entresto;In the study group,Dapagliflozin was added to the control group. At 6 months of treatment,NT-proBNP was measured by time-resolved immunofluorescence and Lp-PLA2 was detected by upper transluminometry,and the patients end systolic left ventricular internal diameter,end diastolic left ventricular internal diameter,end diastolic left ventricular volume,ejection fraction,quality left ventricular index,remodeling index,and mace and adverse effects were recorded during the treatment follow-up period. Results After treatment,NT-proBNP and Lp-PLA2 levels were lower in both groups(P < 0.05),with the study group significantly lower than the control group(P < 0.05). LVESD,LVEDD,LVEDV,LVMI and LVRI in the two groups were lower than those before treatment(P < 0.05),and LVEF was higher than those before treatment(P < 0.05);LVESD,LVEDD,LVEDV,LVMI and LVRI in the study group were significantly lower than those in the control group(P < 0.05),and LVEF in the study group was significantly higher than those in the control group(P < 0.05). At 3 and 6 months of treatment,the level of 6MWT in the two groups was significantly higher than that at 1 month of treatment(P < 0.05)and at 6 months of treatment,the level of 6MWT in the two groups was significantly higher than that at 3 months of treatment(P < 0.05). The degree of increase in the study group was significantly higher than that in the control group at the same time,with statistical difference(P < 0.05). The incidence of mace in the study group was significantly lower when compared to the control group(P < 0.05);The incid

关 键 词：急性心肌梗死 心力衰竭 诺欣妥 达格列净 心室重构 

分 类 号：R541.4[医药卫生—心血管疾病]