早期应用达格列净在急性心肌梗死急诊经皮冠状动脉介入术后患者中的有效性及安全性  

Efficacy and safety of early application of Dapagliflozin in patients undergoing emergency PCI after acute myocardial infarction

作　　者：王法斌 孙梦涵 赵强[1] 马腾 刘俸君 杨大成[1] WANG Fabin;SUN Menghan;ZHAO Qiang;MA Teng;LIU Fengjun;YANG Dacheng(Division of Cardiology,Tengzhou Central People′s Hospital Affiliated to Jining Medical University,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：《实用医学杂志》2023年第13期1688-1692,共5页The Journal of Practical Medicine

基　　金：山东省医药卫生科技发展计划项目(编号:2016WS0628);济宁医学院教师科研扶持基金项目(编号:JYFC2019FKJ030)。

摘　　要：目的观察早期应用达格列净在急性心肌梗死(AMI)急诊经皮冠状动脉介入(PCI)术后患者中的临床有效性及安全性。方法选取2020年9月至2021年9月收治的AMI急诊PCI术后患者68例作为研究对象。按随机数字表法分为研究组(34例)和对照组(34例)。两组患者急诊PCI术后均给予阿司匹林、替格瑞洛等药物治疗。对照组给予美托洛尔、培哚普利等常规治疗,研究组在常规治疗基础上加用达格列净,疗程6个月。比较两组患者N末端B型钠尿肽前体(NT⁃proBNP)、左心室射血分数(LVEF)、左心室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、心室重构率、心力衰竭发生率、再住院率及不良反应发生情况等指标。结果治疗1、6个月后,两组患者NT⁃proBNP水平较治疗前明显降低,LVEF较治疗前明显提高(P<0.05)。治疗6个月后,与对照组相比较,研究组NT⁃proBNP、LVEDV、LVESV、心室重构及心力衰竭发生率明显降低(P<0.05),且LVEF明显提高(P<0.05)。但两组患者再住院率及药物不良反应发生率均差异无统计学意义(P>0.05)。结论达格列净早期应用可有效减少AMI急诊PCI术后患者心室重构,改善心功能,且安全性相对较好。Objective To investigate the clinical efficacy and safety of early application of Dapagliflozin in patients undergoing emergency percutaneous coronary intervention(PCI)after acute myocardial infarction(AMI).Methods AMI patients undergoing emergency PCI(n=68)were chosen from the Tengzhou Central People′s Hospital from September 2020 to September 2021,and divided randomly into control group(n=34)and research group(n=34).Both groups of patients were given aspirin,ticagrelor,etc after PCI.The control group received conventional treatments such as metoprolol perindopril,and the research group received dapagliflozin on bases of conventional oral medicine,a course for 6 months.The level of N⁃terminal pro⁃B⁃type natriuretic peptide(NT⁃proBNP),left ventricular ejection fraction(LVEF),left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),ventricular remodeling rate,the incidence of heart failure,the readmission rate,and incidence of adverse reactions were compared between the two groups.Results After 1 month and 6 months of treatment,the levels of NT⁃proBNP in the two groups were significantly lower than before treatment(P<0.05),and LVEF was significantly higher than before treatment(P<0.05).After 6 months of treatment,compared with control group,the levels of NT⁃proBNP、LVEDV、LVESV、ventricular remodeling and Incidence of heart failure were significantly lower(P<0.05),and LVEF was evidently higher in the study group(P<0.05).However,There were no significant differences in the rates of readmission and adverse drug reactions between the two groups(P>0.05).Conclusions Early application of dapagliflozin can effectively reduce ventricular remodeling and improve cardiac function in patients with acute myocardial infarction after emergency PCI,with relatively good safety.

关 键 词：达格列净 急性心肌梗死 冠状动脉介入治疗 心室重构 心功能 

分 类 号：R541.4[医药卫生—心血管疾病] R541.6[医药卫生—内科学]