钠-葡萄糖协同转运蛋白2抑制剂对慢性心力衰竭合并肾功能不全患者心功能及肾功能的影响  

Effect of Sodium Glucose Cotransporter 2 Inhibitor on Cardiac Function and Renal Function in Patients with Chronic Heart Failure Combined with Renal Insufficiency

作　　者：李辛一 孟宪晛 冯高科[1] 宋涛[1] 胡丹[1] 黄燕[1] LI Xinyi;MENG Xianxian;FENG Gaoke;SONG Tao;HU Dan;HUANG Yan(Department of Cardiology,Renmin Hospital of Wuhan University,Wuhan 430060,China;The First Clinical Collage of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院心内科,湖北省武汉市430060 [2]武汉大学第一临床学院,湖北省武汉市430060

出　　处：《实用心脑肺血管病杂志》2023年第3期105-109,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：国家自然科学基金资助项目(82100331,82270332);武汉市知识创新专项项目(2022020801020484);中央高校自主科研项目(2042019kf0058,2042022kf1217)。

摘　　要：目的探讨钠-葡萄糖协同转运蛋白2(SGLT-2)抑制剂对慢性心力衰竭合并肾功能不全患者心功能及肾功能的影响。方法回顾性收集2022年1—7月于武汉大学人民医院就诊的慢性心力衰竭合并肾功能不全患者88例为研究对象,根据治疗方案将患者分为对照组(n=52)与观察组(n=36)。对照组患者采用标准抗心力衰竭药物进行常规治疗,观察组患者在对照组治疗基础上给予SGLT-2抑制剂,两组患者均连续用药3个月。比较两组治疗前后实验室检查指标〔N末端脑钠肽前体(NT-proBNP)、估算肾小球滤过率(eGFR)〕、超声心动图检查指标〔左心室舒张末期内径(LVEDD)、室间隔厚度(IVST)、左心室后壁舒张末期厚度(LVPWT)、左心室射血分数(LVEF)〕。结果治疗前两组NT-proBNP比较,差异无统计学意义(P>0.05);两组治疗后NT-proBNP分别低于本组治疗前,且治疗后观察组NT-proBNP低于对照组(P<0.05)。治疗前及治疗后,两组eGFR比较,差异无统计学意义(P>0.05);两组治疗前eGFR分别与本组治疗后比较,差异无统计学意义(P>0.05)。治疗前及治疗后,观察组LVEDD大于对照组(P<0.05);治疗前及治疗后,两组IVST、LVPWT、LVEF比较,差异无统计学意义(P>0.05);对照组治疗前与治疗后LVEDD、IVST、LVPWT、LVEF比较,差异无统计学意义(P>0.05);观察组治疗后LVEDD小于治疗前,LVEF高于治疗前(P<0.05);观察组治疗前与治疗后IVST、LVPWT比较,差异无统计学意义(P>0.05)。结论SGLT-2抑制剂可改善慢性心力衰竭合并肾功能不全患者的心功能,但短期内对心室重构、肾功能无明显影响。Objective To investigate the effect of sodium glucose cotransporter 2(SGLT-2)inhibitor on cardiac function and renal function in patients with chronic heart failure combined with renal insufficiency.Methods A total of 88 patients with chronic heart failure combined with renal insufficiency in Renmin Hospital of Wuhan University from January to July in 2022 were retrospectively selected.The patients were divided into control group(n=52)and observation group(n=36)according to the treatment plan.Patients in the control group were conventionaly treated with standard anti-heart failure drugs,patients in the observation group were treated with SGLT-2 inhibitor on the basis of the control group,and they were treated continuously for 3 months.The laboratory indicators[N-terminal pro-brain natriuretic peptide(NT-proBNP),estimate glomerular filtration rate(eGFR)],echocardiographic indexes[left ventricular end diastolic diameter(LVEDD),interventricular septal thickness(IVST),left ventricular posterior wall end-diastolic thickness(LVPWT),left ventricular ejection fraction(LVEF)]were compared between the two groups before and after treatment.Results Before treatment,there was no statistically significant difference in NT-proBNP between the two groups(P>0.05);after treatment,the NT-proBNP in the two groups was lower than that before treatment,respectively(P<0.05);after treatment,the NT-proBNP in the observation group was lower than that in the control group(P<0.05).Before and after treatment,there was no statistically significant difference in eGFR between the two groups(P>0.05);there was no statistically significant difference in eGFR in the two groups before and after treatment(P>0.05).Before and after treatment,the LVEDD in the observation group was greater than that in the control group(P<0.05).Before and after treatment,there was no statistically significant difference in IVST,LVPWT,LVEF between the two groups(P>0.05).There was no statistically significant difference in LVEDD,IVST,LVPWT,LVEF in the control group before an

关 键 词：心力衰竭 肾功能不全 钠-葡萄糖协同转运蛋白2抑制剂 N末端脑钠肽前体 估算肾小球滤过率 

分 类 号：R541.6[医药卫生—心血管疾病]