达格列净对ST段抬高心肌梗死非糖尿病老年患者急诊经皮冠脉介入术术后心肌微循环及近期预后的影响  

Effect of Dapagliflozin on Myocardial Microcirculation and Short-Term Prognosis in Non-Diabetic Elderly Patients with ST Segment Elevation Myocardial Infarction Undergoing Emergency Primary Percutaneous Coronary Intervention

作　　者：王要鑫 秦啸鸣 刘洁云 秦雷 张帅 郭秋红 WANG Yao-xin;QIN Xiao-ming;LIU Jie-yun;QIN Lei;ZHANG Shuai;GUO Qiu-hong(Department of Cardiovascular Medicine,Kaifeng Central Hospital,Kaifeng 475000,China;Shanghai Tenth People's Hospital,Tongji University School of Medicine,Shanghai 200072,China)

机构地区：[1]开封市中心医院心血管内科,开封475000 [2]同济大学附属上海市第十人民医院,上海200072

出　　处：《中国合理用药探索》2024年第8期91-96,共6页Chinese Journal of Rational Drug Use

基　　金：河南省医学科技攻关联合共建项目(LHGJ20220929)。

摘　　要：目的:探讨达格列净对ST段抬高心肌梗死(STEMI)非糖尿病老年患者急诊经皮冠脉介入术(PPCI)术后心肌微循环及近期预后的影响。方法:选取2019年5月~2021年1月在某院行PPCI手术治疗的90例STEMI非糖尿病老年患者作为研究对象,采用随机数字表法分为对照组和观察组,每组45例。对照组给予常规治疗,观察组在对照组基础上给予达格列净片治疗。比较两组患者心功能[左室舒张末内径(LVEDD)、左室射血分数(LVEF)、N端B型脑钠肽前体(NT-proBNP)]、心肌微循环[造影评分指数(CSI)]、血生化指标[葡萄糖(Glu)、尿酸(UA)、白介素-6(IL-6)],并记录两组患者治疗期间不良心血管事件发生情况。结果:治疗后,观察组LVEDD和CSI小于对照组(P<0.05);观察组UA、IL-6、NT-proBNP水平低于对照组(P<0.05);两组患者不良心血管事件总发生率比较无统计学差异(P>0.05)。结论:对于PPCI术后STEMI非糖尿病老年患者,达格列净可带来多种获益,同时可改善心肌微循环,且不增加不良心血管事件。Objective:To investigate the effect of dapagliflozin on myocardial microcirculation and short-term prognosis in non-diabetic elderly patients with ST segment elevation myocardial infarction(STEMI)undergoing emergency primary percutaneous coronary intervention(PPCI).Methods:A total of 90 non-diabetic elderly patients with STEMI who underwent PPCI in a hospital from May 2019 to January 2021 were selected and divided into control group and observation group by random number table,with 45 patients in each group.The control group was given conventional treatment,and the observation group was given dapagliflozin tablets in addition to the treatment given in the control group.The cardiac function[left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),N-terminal pro-B-type natriuretic peptide(NT-proBNP)],myocardial microcirculation[contrast score index(CSI)],and blood biochemistry parameters[glucose(Glu),uric acid(UA),interleukin-6(IL-6)]were compared between the two groups,and the occurrence of treatment-emergent adverse cardiovascular events was recorded.Results:After treatment,LVEDD and CSI in the observation group were lower than those in the control group(P<0.05).The levels of UA,IL-6 and NT-proBNP in the observation group were lower than those in the control group(P<0.05).There was no statistically significant difference in the total incidence of adverse cardiovascular events between the two groups(P>0.05).Conclusion:For non-diabetic elderly patients with STEMI undergoing PPCI,dapagliflozin provides multiple benefits,while improving myocardial microcirculation,and no adverse cardiovascular events in the short term are increased.

关 键 词：达格列净 非糖尿病 ST段抬高心肌梗死 急诊经皮冠脉介入术 心肌微循环 

分 类 号：R541[医药卫生—心血管疾病]