沙库巴曲缬沙坦联合达格列净治疗射血分数减低型心力衰竭的疗效及对患者血清心肌肌钙蛋白I和B型脑钠肽水平的影响  

The efficacy of sacubitril valsartan combined with dapagliflozin in the treatment of heart failure with reduced ejection fraction and its impact on serum levels of cardiac troponin I and B-type natriuretic peptide in patients

作　　者：沈相福 郑俊良 张静 SHEN Xiangfu;ZHENG Junliang;ZHANG Jing(Department of Cardiovascular Medicine,Pingxiang Mining Group Co.,Ltd.General Hospital,Pingxiang,Jiangxi,337000,China)

机构地区：[1]萍乡矿业集团有限公司总医院心血管内科,江西萍乡337000

出　　处：《当代医学》2024年第20期78-82,共5页Contemporary Medicine

摘　　要：目的探究沙库巴曲缬沙坦联合达格列净治疗射血分数减低型心力衰竭的疗效及对患者血清心肌肌钙蛋白(I cardiac troponin I,cTnI)、B型脑钠肽(B-type natriuretic peptide,BNP)水平的影响。方法选取2020年1月至2022年3月萍乡矿业集团有限公司总医院收治的80例射血分数减低型心力衰竭患者作为研究对象,随机分为A组与B组,各40例。A组采用沙库巴曲缬沙坦治疗,B组采用沙库巴曲缬沙坦联合达格列净治疗,比较两组临床疗效、心功能指标、血压、肾功能指标。结果B组治疗总有效率为97.50%,高于A组的82.50%,差异有统计学意义(P<0.05)。治疗后,两组左心室舒张期末内径(left ventricular end diastolic diameter,LVEDD)、左心室收缩期末内经(left ventricular end systolic diameter,LVESD)均短于治疗前,cTnI、BNP水平均低于治疗前,左心室射血分数(left ventricular ejection fraction,LVEF)均高于治疗前,6 min步行实验(6 min walking test,6MWT)均长于治疗前,且B组LVEDD、LVESD均短于A组,cTnI、BNP水平均低于A组,LVEF高于A组,6MWT长于A组,差异有统计学意义(P<0.05)。治疗后,两组收缩压(systolic blood pressure,SBP)及B组舒张压(diastolic blood pressure,DBP)水平均低于治疗前,且B组SBP、DBP水平均低于A组,差异有统计学意义(P<0.05)。治疗前后,两组血肌酐、尿素氮水平比较差异无统计学意义。两组不良反应发生率比较差异无统计学意义。结论沙库巴曲缬沙坦联合达格列净治疗射血分数减低型心力衰竭患者疗效显著,可显著改善患者心功能指标,抑制心室重构,降低患者血压水平,且未增加治疗不良发应,值得临床推广应用。Objective To investigate the effect of sacubitril valsartan combined with dapagliflozin in the treatment of heart failure with reduced ejection fraction and its impact on the levels of serum cardiac troponin I(cTnI)and B-type natriuretic peptide(BNP)in patients.Methods 80 patients with reduced ejection fraction heart failure admitted to Pingxiang Mining Group Co.,Ltd.General Hospital from January 2020 to March 2022 were selected as the study subjects,and they were randomly divided into the group A and the group B,with 40 cases in each group.The group A was treated with sacubitril valsartan,while the group B was treated with sacubitril valsartan combined with dapagliflozin.The clinical efficacy,cardiac function,blood pressure and renal function were compared between the two groups.Results The total effective rate of treatment in the group B was 97.50%,which was higher than 82.50% in the group A,and the difference was statistically significant(P<0.05).After treatment,the end diastolic diameter(LVEDD)and end systolic diameter(LVESD)of the two groups were shorter than before treatment,and the levels of cTnI and BNP were lower than before treatment,the left ventricular ejection fraction(LVEF)was higher than before treatment,and the 6 min walking test(6MWT) was longer than before treatment,LVEDD and LVESD in the group B were shorter than those in the group A,cTnI and BNP levels were lower than those in the group A,LVEF was higher than group A,and 6MWT was longer than group A,and the differences were statistically significant(P<0.05).After treatment,the levels of systolic blood pressure(SBP)and diastolic blood pressure(DBP)of the two groups were lower than before treatment,and the levels of SBP and DBP in the group B were lower than those in the group A,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the levels of serum creatinine and urea nitrogen between the two groups before and after treatment.There was no statistically significant difference in the inc

关 键 词：射血分数减低型心力衰竭 沙库巴曲缬沙坦 达格列净 

分 类 号：R54[医药卫生—心血管疾病]