沙库巴曲缬沙坦联用达格列净对老年慢性心力衰竭患者心肾功能的影响  

Effects of sacubitril/valsartan combined with dapagliflozin on cardiac and renal function in elderly patients with chronic heart failure

作　　者：田佳文 朱菲白[1,2] 陈梦伟 马潇泓[1,2] 翁婷雯 Tian Jiawen;Zhu Feibai;Chen Mengwei;Ma Xiaohong;Weng Tingwen(Department of Cardiology,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China;Department of Geriatrics,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China)

机构地区：[1]复旦大学附属华东医院心血管内科,上海200040 [2]复旦大学附属华东医院老年医学科,上海200040

出　　处：《老年医学与保健》2024年第2期315-319,335,共6页Geriatrics & Health Care

基　　金：上海市级医院老年医学科临床能力促进与提升专科联盟项目(SHDC22023302)。

摘　　要：目的观察沙库巴曲缬沙坦联用达格列净对老年慢性心力衰竭患者的临床治疗效果。方法回顾性选取2018年7月-2022年10月期间,复旦大学附属华东医院心血管内科收治的老年慢性心力衰竭患者271例,其中,单纯应用缬沙坦的治疗1组89例、应用沙库巴曲缬沙坦的治疗2组90例、应用沙库巴曲缬沙坦联用达格列净的治疗3组92例。3组连续用药12(1013.5)个月,比较3组治疗前后血肌酐、尿酸、左室舒张末内径(LVEDD)、左室射血分数(LVEF)、脑钠肽(BNP)水平。结果经治疗12(1013.5)个月后,治疗3组的临床有效率95.7%,高于治疗1组的80.9%(P<0.05)。与治疗前比较,各组心功能指标均获得改善,治疗3组肾功能指标获得改善(P<0.05)。LVEF改善方面,治疗3组及治疗2组均优于治疗1组;LVEDD、血肌酐和尿酸改善方面,治疗3组优于治疗2组及治疗1组;BNP改善方面,治疗3组优于治疗1组,以上结果均具有统计学差异(P<0.05)。结论3组方案均可改善老年慢性心力衰竭患者的心、肾功能指标,但是相较于单纯应用缬沙坦或沙库巴曲缬沙坦,沙库巴曲缬沙坦联用达格列净治疗老年慢性心力衰竭患者,心肾获益最大。Objective To observe the clinical therapeutic effects of sacubitril/valsartan combined with dapagliflozin on elderly patients with chronic heart failure.Methods A total of 271 elderly patients with chronic heart failure treated in Department of Cardiology of Huadong Hospital Affiliated to Fudan University from July 2018 to October 2022 were retrospectively selected.Among them,there were 89 cases in treatment group 1 treated with valsartan alone,90 ones in treatment group 2 treated with sacubitril/valsartan,and 92 ones in treatment group 3 treated with sacubitril valsartan combined with dapagliflozin.All three groups were treated continuously for 12(10-13.5)months.The levels of serum creatinine,uric acid,left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)and brain natriuretic peptide(BNP)were compared among the three groups before and after treatment.Results After 12(10-13.5)months of treatment,the clinical effective rate of the treatment group 3 was 95.7%,which was significantly higher than that of the treatment group 1(80.9%)(P<0.05).Compared with before treatment,the cardiac function indexes in all groups were significantly improved,and renal function indexes in the treatment group 3 were significantly improved(P<0.05).In terms of LVEF improvement,the treatment group 3 and treatment group 2 were superior to the treatment group 1.In terms of LVEDD,serum creatinine,and uric acid improvement,the treatment group 3 was superior to the treatment group 2 and treatment group 1.In terms of BNP improvement,the treatment group 3 was superior to the treatment group 1.All the above results were statistically significant(P<0.05).Conclusion All three treatment regimens can improve the cardiac and renal function indicators in elderly patients with chronic heart failure.However,compared to the use of valsartan alone or sacubactril/valsartan,the combination of sacubitril/valsartan with dapagliflozin in the treatment of elderly patients with chronic heart failure has the greatest cardiac and re

关 键 词：沙库巴曲缬沙坦 达格列净 老年 慢性心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]