达格列净在非糖尿病射血分数轻度降低的心力衰竭患者中的应用效果  

Efficacy of Dapagliflozin in the treatment of patients without diabetes mellitus in heart failure with mildly reduced ejection fraction

作　　者：王法斌 马腾 赵强[1] 杨大成[1] WANG Fabin;MA Teng;ZHAO Qiang;YANG Dacheng(Division of Cardiology,Tengzhou Central People's Hospital Affiliated to Jining Medical University,Shandong Province,Tengzhou,277500,China)

机构地区：[1]济宁医学院附属滕州市中心人民医院心内科,山东滕州277500

出　　处：《中国当代医药》2023年第4期82-86,共5页China Modern Medicine

摘　　要：目的观察达格列净在非糖尿病射血分数轻度降低的心力衰竭(HFmrEF)患者中应用效果。方法选取2020年5月至2021年5月滕州市中心人民医院收治的103例HFmrEF(非糖尿病)患者作为研究对象,采用掷硬币法分为对照组(55例)和观察组(48例)。对照组采用标准的心力衰竭治疗方案(含沙库巴曲缬沙坦),观察组在标准心力衰竭治疗基础上加用达格列净,随访治疗6个月。比较两组患者治疗前后空腹血糖(FBG)、糖化血红蛋白(HbA1c)、N末端B型钠尿肽前体(NT-proBNP)、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、6 min步行试验(6MWT)距离、纽约心脏病协会(NYHA)分级、临床疗效及再住院率情况等指标,并监测不良反应发生情况。结果治疗前FBG、HbA1c、NT-proBNP、LVEF、LVEDD、6MWT距离及NYHA分级比较,差异无统计学意义(P>0.05)。治疗6个月后,两组患者的NT-proBNP、LVEDD低于本组治疗前,同时LVEF、6MWT距离高于本组治疗前,差异有统计学意义(P<0.05)。观察组NT-proBNP、LVEDD、再住院率低于对照组,差异有统计学意义(P<0.05)。观察组LVEF、6MWT距离、总有效率高于对照组,差异有统计学意义(P<0.05)。两组患者不良反应的总发生率比较,差异无统计学意义(P>0.05)。结论达格列净用于非糖尿病HFmrEF患者的治疗,可进一步改善患者临床症状,降低再住院率,且安全性较好。Objective To observe the efficacy of Dapagliflozin in the treatment of patients without diabetes mellitus in heart failure with mildly reduced ejection fraction(HFmrEF).Methods A total of 103 patients of HFmrEF without diabetes mellitus admitted to Tengzhou Central People's Hospital from May 2020 to May 2021 were selected as the research subjects,and they were divided into the control group(n=55)and the observation group(n=48)according to coin toss method.Patients in control group received standard treatment with Sacubitril-Valsartan,patients received standard treatment combined with Dapagliflozin.Follow-up treatment for 6 months was conducted.The fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),N-terminal pro-B-type natriuretic peptide(NT-proBNP),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),6-minute walking test(6MWT)distance,New York Heart Association(NYHA)grading,clinical efficacy,rehospitalization rate were compared between the two groups before and after treatment,Adverse reactions were also monitored.Results Before treatment,there were no statistically significant differences in FPG,HbA1c,NT-proBNP,LVEF,LVEDD,6MWT distance and NYHA grading between the two groups(P>0.05).After 6 months of treatment,NT-proBNP and LVEDD of two groups were lower than those before treatment,the LVEF and 6MWT distance were higher than those before treatment,the differences were statistically significant(P<0.05).The NT-proBNP,LVEDD and re-hospitalization rate in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The LVEF,6MWT distance and clinical efficacy of the observation group were higher than those of the control group,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence rate of adverse reactions between two groups of patients(P>0.05).Conclusion For the treatment of HFmrEF without diabetes mellitus,Dapagliflozin can significantly improve the clini

关 键 词：达格列净 射血分数轻度降低的心力衰竭 沙库巴曲缬沙坦 临床疗效 

分 类 号：R541.6[医药卫生—心血管疾病]