达格列净治疗心力衰竭合并慢性肾脏病的临床观察  

Clinical observation of dapagliflozin in the treatment of heart failure combined with chronic kidney disease

作　　者：杨志云[1] 朱永军[2] 蔡锋[3] 马红岩[4] 田爱英 YANG Zhiyun;ZHU Yongjun;CAI Feng;MA Hongyan;TIAN Aiying(School of Clinical Medicine,Shangqiu Medical College,Henan Shangqiu 476000,China;Dept.of Cardiology,Shangqiu First People’s Hospital/the First Affiliated Hospital of Shangqiu Medical College,Henan Shangqiu 476100,China;Dept.of Gastroenterology and Hepatobiliary Surgery,Shangqiu First People’s Hospital/the First Affiliated Hospital of Shangqiu Medical College,Henan Shangqiu 476100,China;Diagnostic Teaching and Research Office,Shangqiu Medical College,Henan Shangqiu 476000,China;Dept.of Gastroenterology,Shangqiu First People’s Hospital/the First Affiliated Hospital of Shangqiu Medical College,Henan Shangqiu 476100,China)

机构地区：[1]商丘医学高等专科学校临床医学院,河南商丘476000 [2]商丘市第一人民医院/商丘医学高等专科学校第一附属医院心内科,河南商丘476100 [3]商丘市第一人民医院/商丘医学高等专科学校第一附属医院胃肠肝胆外科,河南商丘476100 [4]商丘医学高等专科学校诊断学教研室,河南商丘476000 [5]商丘市第一人民医院/商丘医学高等专科学校第一附属医院消化内科,河南商丘476100

出　　处：《中国药房》2024年第20期2512-2516,共5页China Pharmacy

基　　金：河南省医学科技攻关计划项目(No.LHGJ20200935)。

摘　　要：目的探讨达格列净对心力衰竭(HF)合并慢性肾脏病(CKD)患者心功能、肾功能、血糖、生活质量的影响及用药安全性。方法选择2021年1月1日至2023年1月1日商丘市第一人民医院收治的156例HF合并CKD患者,根据随机数字表法分为常规治疗组(n=80)和达格列净组(n=76)。常规治疗组患者给予常规治疗,达格列净组患者在常规治疗的基础上给予达格列净片10mg,口服,每日1次。两组患者均治疗6个月。观察两组患者治疗前后的心功能[左室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、氨基末端脑利钠肽前体(NT-proBNP)]、肾功能[血肌酐、尿素氮、尿白蛋白排泄率(UAER)、肾小球滤过率(GFR)、肌酐清除率(CCR)]、糖化血红蛋白水平、生活质量,并记录不良反应发生情况。结果治疗后,两组患者的LVESD、LVEDD、NT-proBNP、血肌酐、尿素氮、UAER及达格列净组患者的糖化血红蛋白水平均显著低于同组治疗前,且达格列净组显著低于常规治疗组;LVEF、GFR、CCR、堪萨斯城心肌病问卷评分均显著高于同组治疗前,且达格列净组显著高于常规治疗组(P<0.05)。常规治疗组患者治疗前后的糖化血红蛋白水平比较,差异无统计学意义(P>0.05)。两组患者的头晕、皮疹、肝功能不全、泌尿系统感染、新发透析、低血压的发生率比较,差异均无统计学意义(P>0.05)。结论达格列净能够改善HF合并CKD患者的心功能和肾功能,提高患者的生活质量,降低血糖水平,且未增加不良反应的发生风险。OBJECTIVE To explore the effect and safety of dapagliflozin on cardiac function and renal function,blood glucose,and quality of life in patients with heart failure(HF)combined with chronic kidney disease(CKD).METHODS A total of 156 patients with HF combined with CKD admitted to Shangqiu First People’s Hospital from January 1,2021 to January 1,2023 were included.According to the random number table,the patients were randomly divided into conventional treatment group(n=80)and dapagliflozin group(n=76).Conventional treatment group was given conventional treatment;dapagliflozin group was additionally given Dapagliflozin tablets 10 mg orally,once a day,based on conventional treatment group.Both groups were treated for 6 months.Cardiac function[left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left·2512·China Pharmacy 2024 Vol.35 No.20 ventricular end-diastolic diameter(LVEDD),N-terminal pro-brain natriuretic peptide(NT-proBNP)],renal function[blood creatinine,urea nitrogen,urinary albumin excretion rate(UAER),glomerular filtration rate(GFR),creatinine clearance rate(CCR)],glycosylated hemoglobin,and the quality of life were observed in 2 groups before and after treatment.The occurrence of ADR was recorded.RESULTS After treatment,LVESD,LVEDD,NT-proBNP,blood creatinine,urea nitrogen,UAER in 2 groups as well as the level of glycosylated hemoglobin in dapagliflozin group were significantly lower than before treatment;the dapagliflozin group was significantly lower than the conventional treatment group.LVEF,GFR,CCR and Kansas City Cardiomyopathy Questionnaire score were significantly higher than before treatment,and the dapagliflozin group was significantly higher than the conventional treatment group(P<0.05).There was no statistical significance in glycosylated hemoglobin of conventional treatment group before and after treatment(P>0.05).There was no statistically significant difference in the incidence of dizziness,rash,liver dysfunction,urinary system infection,new dialysis and h

关 键 词：达格列净 心力衰竭 慢性肾脏病 心功能 肾功能 安全性 

分 类 号：R977.15[医药卫生—药品]