卡格列净联合沙库巴曲缬沙坦口服对非糖尿病射血分数保留心力衰竭的治疗效果观察  

Therapeutic effect of canagliflozin combined with sacubitril/valsartan in non-diabetic patients with HFpEF

作　　者：张存新[1] 陈俊华 黄卫芳 蓝晓燕 ZHANG Cunxing;CHEN Junhua;HUANG Weifang;LAN Xiaoyan(Department of Cardiology,Xinjiang Provincial Corps Hospital of Chinese Armed Police Force,Urumqi 830000,China)

机构地区：[1]新疆武警总队医院心内科,新疆乌鲁木齐830000

出　　处：《山东医药》2025年第1期10-14,共5页Shandong Medical Journal

摘　　要：目的观察卡格列净联合沙库巴曲缬沙坦口服治疗非糖尿病射血分数保留心力衰竭(HFpEF)的效果。方法选取非糖尿病HFpEF患者70例,按照随机数字表法分为观察组、对照组,每组各35例。观察组在常规治疗基础上予卡格列净(100 mg,1次/天)、沙库巴曲缬沙坦(25~200 mg,2次/天)口服,对照组在常规治疗基础上予加沙库巴曲缬沙坦(25~200 mg,2次/天)口服。分别于治疗前后检测两组血压;抽取两组外周静脉血,检测血糖、血尿酸、N末端脑钠肽前体(NT-proBNP)、高敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6);采用超声心动图测算两组左心室射血分数(LVEF)、左心房内径(LAD)、左心室舒张末期内径(LVEDD)及E/A值;采用6 min步行试验及纽约心功能分级(NYHA)评估两组心功能,根据心功能改善情况评价治疗效果。结果与对照组相比,治疗后观察组收缩压、舒张压均降低(P均<0.05)。与治疗前相比,治疗后两组外周血NT-proBNP、hs-CRP、IL-6水平均降低,且观察组降低更明显(P均<0.05)。与治疗前相比,治疗后两组E/A值均升高,且观察组升高更明显(P均<0.05)。与治疗前相比,治疗后观察组、对照组6 min步行距离均增加(P均<0.05);与对照组相比,治疗后观察组6 min步行距离增长(P<0.05)。观察组心功能改善率高于对照组(P<0.05)。结论卡格列净联合沙库巴曲缬沙坦口服治疗非糖尿病HFpEF的效果较好,可通过降压、减轻心脏前后负荷、防止或逆转心肌重塑等机制改善患者的心功能。Objective To observe the effect of canagliflozin combined with oral sacubitril/valsartan in the treatment of non-diabetic heart failure with preserved ejection fraction(HFpEF).Methods Seventy non-diabetic HFpEF patients were randomly divided into the observation group and control group,with 35 cases in each group.Patients in the observation group were given canagliflozin(100 mg,once a day)and sacubitril/valsartan(25-200 mg,twice a day)orally on the basis of conventional treatment,while patients in the control group were given sacubitril/valsartan(25-200 mg,twice a day)orally on the basis of conventional treatment.Blood pressure,blood glucose,BMI and uric acid of the two groups were detected before and after treatment.Peripheral venous blood of the two groups were collected before and after treatment,and serum N-terminal brain natriuretic peptide precursor(NT-proBNP),high-sensitive C-reactive protein(hs-CRP)and interleukin-6(IL-6)were detected.Ventricular ejection fraction(LVEF),left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDD)and E/A values were calculated by echocardiography.The cardiac function was evaluated by New York Heart Association(NYHA)and 6-minute walking test.The therapeutic effect was evaluated according to the improvement of cardiac function.Results Compared with the control group,systolic blood pressure and diastolic blood pressure decreased in the observation group after treatment(both P<0.05).Compared with those before treatment,the levels of serum NT-proBNP,hs-CRP,and IL-6 decreased in the two groups after treatment,and the decrease was more significant in the observation group(all P<0.05).Compared with those before treatment,the E/A values of both groups increased after treatment,and the increase was more obvious in the observation group(P<0.05).The 6-minute walking distance of the observation group and control group increased after treatment in comparison with that before treatment(P<0.05).Compared with the control group,the observation group had a longer 6-minute walking

关 键 词：卡格列净 沙库巴曲缬沙坦 心力衰竭 射血分数保留心力衰竭 

分 类 号：R587.1[医药卫生—内分泌]