达格列净对射血分数降低的心力衰竭合并低血压状态患者的临床疗效  

Clinical Efficacy of Dapagliflozin in Heart Failure Patients with Reduced Ejection Ejection Fraction

作　　者：崔留义 赵子明 陈愿 陈俭 CUI Liuyi;ZHAO Ziming;CHEN Yuan;CHEN Jian(Department of Cardiology,Zhengzhou Cardiovascular Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市心血管病医院心血管内科,河南郑州450000

出　　处：《河南医学研究》2025年第1期24-28,共5页Henan Medical Research

摘　　要：目的探讨达格列净对射血分数降低的心力衰竭(HFrEF)合并低血压状态患者的临床疗效。方法选取2021年10月至2022年6月入住郑州市心血管病医院心内科的130例合并低血压状态的HFrEF患者,随机分为对照组和观察组,各65例。对照组接受常规药物治疗,观察组除常规药物外均加用达格列净,对所有患者进行12个月的随访。主要终点为患者再发心力衰竭住院、心血管死亡等,次要终点包括血压、心率、6分钟步行试验距离、氨基末端脑钠肽前体(NT-proBNP)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)等,记录12个月治疗期间两组患者不良事件的发生情况(肾功能异常、血钾水平异常、血容量不足、低血糖等)。结果治疗12个月后,观察组再发心力衰竭住院、心血管死亡较对照组低(P<0.05)。观察组心率、LVEDD、NT-proBNP均低于对照组,收缩压、6分钟步行试验距离、LVEF均高于对照组(P<0.05)。两组之间不良事件发生情况差异无统计学意义(P>0.05)。多因素Cox回归分析,达格列净是心力衰竭再入院(HR=0.551,95%CI:0.319~0.952,P=0.033)和心血管死亡(HR=0.317,95%CI:0.153~0.656,P=0.002)的独立影响因素。结论达格列净能够提升HFrEF合并低血压状态患者的心功能,降低心力衰竭再入院率及心血管死亡率,且不增加不良事件的发生风险。Objective To investigate the clinical evaluation of dapagliflozin in heart failure patients with reduced ejection fraction(HFrEF).Methods A total of 130 HFrEF patients with hypotension admitted to the Cardiology Department of Zhengzhou Cardiovascular Hospital from October 2021 to June 2022 were randomly divided into control group and observation group,with 65 cases in each group.The control group was treated with conventional drugs,and the observation group was treated with dapagliflozin in addition to conventional drugs.All patients were followed up for 12 months.The primary end point included the patient’s hospitalization for recurrence of heart failure,cardiovascular death.The secondary endpoint included blood pressure,heart rate,6 minutes walking test distance,left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),N-terminal pro-brain natriuretic peptide(NT-proBNP).Adverse events(abnormal renal function,abnormal blood potassium level,hypovolemia,hypoglycemia)were also recorded during the 12 months treatment period in both groups.Results Twelve months after treatment,the patient’s hospitalization for recurrence of heart failure and cardiovascular death in the observation group were lower than that in the control group(P<0.05).Heart rate,LVEDD,NT-proBNP in observation group were lower and systolic blood pressure,6 minutes walking test distance,LVEF were higher than those in control group(P<0.05).There was no significant difference in the adverse events between the two groups(P>0.05).Multivariate Cox regression analysis showed that dapagliflozin use was an independent predictor of readmission rate for recurrence of heart failure(HR=0.551,95%CI:0.319-0.952,P=0.033)and cardiovascular mortality(HR=0.317,95%CI:0.153-0.656,P=0.002)in advanced heart failure patients with hypotension.Conclusion Dapagliflozin improves cardiac function in HFrEF patients with hypotension,reduces heart failure readmitted rates and cardiovascular mortality,and does not increase the risk of adverse events

关 键 词：心力衰竭 射血分数降低 达格列净 低血压 

分 类 号：R541.4[医药卫生—心血管疾病]