达格列净在非糖尿病急性心肌梗死患者择期经皮冠状动脉介入治疗中的应用效果  

Application Effect of Dapagliflozin in Non-Diabetic Patients with Acute Myocardial Infarction Undergoing Elective Percutaneous Coronary Intervention

作　　者：张梦 张亚丹 陈雅婕 邓伟[1,2] 杨政 徐昌武[1,2] 严玲 付金容[1,2] 孟妍妍 ZHANG Meng;ZHANG Yadan;CHEN Yajie;DENG Wei;YANG Zheng;XU Changwu;YAN Ling;FU Jinrong;MENG Yanyan(Department of Cardiology,Renmin Hospital of Wuhan University,Wuhan 430060,China;Hubei Key Laboratory of Metabolic and Chronic Diseases,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院心血管内科,湖北省武汉市430060 [2]代谢与相关慢病湖北省重点实验室,湖北省武汉市430060

出　　处：《实用心脑肺血管病杂志》2025年第3期105-110,共6页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：国家重点研发计划“重大慢性非传染性疾病防控研究”重点专项2018年度定向项目(2018YFC1311300);国家自然科学基金资助项目(82100256)。

摘　　要：目的探讨达格列净在非糖尿病急性心肌梗死(AMI)患者择期经皮冠状动脉介入治疗(PCI)中的应用效果。方法选取2021年1月—2023年2月于武汉大学人民医院行择期PCI的非糖尿病AMI患者104例作为研究对象,采用随机数字表法将患者分为对照组53例与达格列净组51例。对照组患者采用常规药物治疗,达格列净组患者在对照组基础上加用达格列净治疗。两组患者均于择期PCI前3 d开始用药至术后1年。比较两组用药前、术后48 h心功能指标[氨基末端脑钠肽前体(NT-proBNP)比值、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、心脏舒张早期二尖瓣血流速度/舒张早期二尖瓣环运动速度(E/e')]、超敏C反应蛋白(hs-CRP)分层、炎症反应指标(单核细胞计数、单核细胞百分数、IL-6、TNF-α),并观察两组主要不良心血管事件(MACE)及药物不良反应发生情况。结果术后48 h,达格列净组NT-proBNP比值低于对照组,LVEDD、E/e'小于对照组,LVEF高于对照组(P<0.05)。术后48 h,达格列净组hs-CRP分层优于对照组,单核细胞百分数、IL-6、TNF-α低于对照组(P<0.05)。两组因心力衰竭再入院、非致死性心肌梗死、非计划性血运重建、死亡发生率比较,差异无统计学意义(P>0.05)。两组药物不良反应总发生率比较,差异无统计学意义(P>0.05)。结论达格列净可有效改善非糖尿病AMI患者择期PCI后心脏重构,减轻心肌损伤及炎症反应,降低心血管疾病发生风险,且不会增加MACE发生风险,安全性较高。Objective To investigate the application effect of dapagliflozin in non-diabetic patients with acute myocardial infarction(AMI)undergoing elective percutaneous coronary intervention(PCI).Methods A total of 104 cases of non-diabetic patients with AMI who underwent elective PCI in the Renmin Hospital of Wuhan University were selected as study objects,and patients were divided into the control group(n=53)and the dapagliflozin group(n=51)according to the random number table method.Patients in the control group received conventional treatment,while patients in the dapagliflozin group received dapagliflozin on the basis of the control group.Patients in both groups were taken drugs from 3 days before elective PCI to 1 year after operation.Cardiac function indexes[N-terminal pro-brain natriuretic peptide(NT-proBNP)ratio,left ventricular end diastolic dimension(LVEDD),left ventricular ejection fraction(LVEF),ratio of early diastolic mitral flow velocity to early diastolic mitral annular motion velocity(E/e')],hypersensitive C-reactive protein(hs-CRP)classify,inflammatory response indexes(monocyte count,percentage of monocytes,IL-6,TNF-α)before medication and after 48 h of operation were compared between the two groups,and incidence of major adverse cardiovascular events(MACE)and drug adverse reactions of the two groups were observed.Results After 48 h of operation,NT-proBNP ratio in the dapagliflozin group was lower than that in the control group,LVEDD and E/e'were less than those in the control group,LVEF was higher than that in the control group(P<0.05).After 48 h of operation,hs-CRP classify in the dapagliflozin group was better than that in the control group,percentage of monocytes,IL-6 and TNF-αwere lower than those in the control group(P<0.05).There was no significant difference in the incidence of readmission due to heart failure,non-fatal myocardial infarction,unplanned revascularization and mortality between the two groups(P>0.05).There was no statistically significant difference in the overall incidence of dru

关 键 词：心肌梗死 非糖尿病 经皮冠状动脉介入治疗 达格列净 心脏重构 炎症 预后 

分 类 号：R542.22[医药卫生—心血管疾病]