达格列净治疗扩张型心肌病伴心力衰竭患者的临床疗效观察  

Clinical observation of dapagliflozin in the treatment of patients with dilated cardiomyopathy and heart failure

作　　者：倪建伟 王锡田[2] NI Jianwei;WANG Xitian(Department of Cardiovascular Medicine,Jiangnan Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine,Hangzhou 311200,China;First Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 311200,China)

机构地区：[1]浙江中医药大学附属江南医院心血管内科,浙江杭州311200 [2]浙江大学医学院附属第一医院,浙江杭州311200

出　　处：《中国现代医生》2022年第27期102-106,共5页China Modern Doctor

摘　　要：目的评价达格列净治疗扩张型心肌病(dilated cardiomyopathy,DCM)伴心力衰竭患者的临床疗效。方法采用随机对照的方法,纳入符合DCM伴心力衰竭诊断标准的患者60例,按照1:1的比例,随机分为两组。对照组给予β受体阻滞剂、醛固酮受体拮抗剂(aldosterone receptor antagonist,MRA)、血管紧张素转换酶抑制剂(angiotensin converting enzyme inhibitors,ACEI)/血管紧张素Ⅱ受体拮抗剂(angiotensinⅡreceptor blockers,ARB)、血管紧张素受体脑啡肽酶抑制剂(angiotensin receptor-neprilysin inhibitor,ARNI)、利尿剂、洋地黄类等药物治疗,观察组在以上抗心力衰竭药物基础上加用达格列净片,比较两组患者治疗前后左心室射血分数(left ventricular ejection fraction,LVEF)、左心室舒张未内经(left ventricular end diastolic diameter,LVEDD)、B型脑钠肽(brain natriuretic peptide,BNP)、6min步行测验(6-minute walk test,6MWT)、体重的变化情况。结果两组患者治疗前后LVEF、LVEDD、BNP、6MWT数据同组内比较,差异均有统计学意义(P<0.01);治疗后两组LVEF比较,差异有统计学意义(P<0.05),两组LVEDD、BNP、6MWT比较,差异无统计学意义(P>0.05),但其差值改善均有统计学意义(P<0.05)。体重监测结果显示,同组内治疗后较治疗前改善,差异有统计学意义(P<0.01);两组治疗后比较,差异无统计学意义(P>0.05),但差值改善均有统计学意义(P<0.05)。对心功能(NYHA分级)评估,同组内治疗前后比较均改善,Z值分别为-3.796和-5.048,差异有统计学意义(P<0.01),两组治疗后比较,观察组改善优于对照组,差异有统计学意义(Z=-2.179,P<0.05)。结论达格列净治疗DCM心力衰竭可提高心功能、改善心力衰竭指标。Objectve To evaluate the clinical efficacy of dapagliflozin in the treatment of patients with dilated cardiomyopathy and heart failure.Methods A total of 60 patients who met the diagnostic criteria for dilated cardiomyopathy and heart failure were enrolled in a randomized controlled trial according to the ratio of 1:1,they were randomly divided into two groups,the control group and the observation group.The control group was treated withβ-blockers,MRA,ACEI/ARB,ARNI,diuretics,digitalis and other drugs,the observation group was given Dapagliflozin tablets on the basis of the above anti-heart failure drugs.Results The data of LVEF,LVEDD,BNP,and 6MWT in the two groups before and after treatment were compared with the same group,and the indicators were improved,and the difference was statistically significant(P<0.01);After treatment,there was a statistically significant difference in LVEF between the two groups(P<0.05),there was no significant difference in LVEDD,BNP and 6MWT between the two groups(P>0.05),but the differences were improved significantly(P<0.05).The results of body weight monitoring showed that the same group improved after treatment compared with before treatment,and the difference was statistically significant(P<0.01).There was no significant difference between the two groups after treatment(P>0.05),but the difference was improved with statistical significance(P<0.05).The evaluation of cardiac function(NYHA classification)was improved in the same group before and after treatment,the Z values were-3.796 and-5.048,respectively,and the difference was statistically significant(P<0.01);The comparison between the two groups after treatment showed that the improvement in the observation group was better than that in the control group,and the difference was statistically significant(Z=-2.179,P<0.05).Conclusion Dapagliflozin is safe and effective in the treatment of patients with dilated cardiomyopathy and heart failure in improving cardiac function and heart failure indicators.

关 键 词：达格列净 扩张型心肌病 心力衰竭 临床疗效 

分 类 号：R972[医药卫生—药品] R542.2[医药卫生—药学]