左西孟旦联合达格列净治疗急性心力衰竭的临床效果  

Clinical efficacy of levosimendan combined with dapagliflozin in the treatment of acute heart failure

作　　者：李雪梦 梁慧 郭学文 李志慧 程仁力[2] LI Xuemeng;LIANG Hui;GUO Xuewen;LI Zhihui;CHENG Renli(Department of Internal Medicine,Suzhou Hospital of Anhui Medical University,Anhui Province,Suzhou 234000,China;不详)

机构地区：[1]安徽医科大学附属宿州医院心内科,安徽省宿州市234000 [2]安徽医科大学附属宿州医院急诊科,安徽省宿州市234000

出　　处：《临床合理用药》2025年第3期1-4,8,共5页Chinese Journal of Clinical Rational Drug Use

基　　金：2023年度宿州市自筹资金项目(SZZCZJ202334);2021年度安徽医科大学学科建设项目(2021GJ03)。

摘　　要：目的 观察左西孟旦联合达格列净治疗急性心力衰竭的临床效果。方法 根据随机数字表法将2021年12月—2023年12月安徽医科大学附属宿州医院收治的急性心力衰竭患者80例进行分组研究,分为试验组40例和对照组40例。对照组给予常规抗心力衰竭药物+达格列净片治疗,试验组在对照组基础上泵入左西孟旦注射液治疗,2组均治疗1周。比较2组临床疗效,治疗前后纽约心脏病协会(NYHA)分级、心率、超声心动图指标、N末端脑钠肽前体(NT-proBNP)、炎性指标,不良反应。结果 试验组治疗总有效率为97.50%,高于对照组的80.00%(χ^(2)=4.507,P=0.034)。治疗1周后,2组NYHA分级较治疗前改善,试验组NYHAⅠ级者占比高于对照组(62.50%vs. 12.50%,χ^(2)=21.333,P<0.001),NYHAⅢ级者占比低于对照组(0 vs. 25.00%,χ^(2)=11.429,P=0.001);2组心率较治疗前下降,且试验组低于对照组(P<0.01);2组左室射血分数较治疗前升高,左室舒张末期内径、左室收缩末期内径较治疗前缩小,且试验组升高/缩小幅度大于对照组(P<0.01);2组血清NT-proBNP、超敏C反应蛋白、肝素结合蛋白及降钙素原水平较治疗前下降,且试验组低于对照组(P<0.01)。试验组与对照组不良反应总发生率比较,差异无统计学意义(17.50%vs. 22.50%,χ^(2)=0.313,P=0.576)。结论 左西孟旦联合达格列净治疗急性心力衰竭的效果显著,可明显改善患者心功能,降低心率,改善心肌酶谱并能够降低炎性因子水平,提高患者生活质量,且安全性较高。Objective To observe the clinical efficacy of levosimendan combined with dapagliflozin in the treatment of AHF.Methods A total of 80 patients with AHF admitted to Suzhou Hospital of Anhui Medical University from December 2021 to December 2023 were collected,and they were divided into groups by the random number table method,which were divided into the experimental group(40 cases)and the control group(40 cases).The control group was treated with conventional anti-heart failure+dapagliflozin tablets,and the experimental group received additional continuous intravenous infusion of levosimendan injection on the basis of the control group,and both groups were treated for 1 week.The clinical efficacy,NYHA functional classification,heart rate,echocardiographic indexes,of levels NT-proBNP and inflammatory indicators before and after treatment,and adverse reactions were compared between the two groups.Results The total effective rate of the experimental group was 97.50%,which was higher than 80.00%of the control group(χ^(2)=4.507,P=0.034).After 1 week of treatment,the NYHA class of the two groups improved compared with that before treatment,and the proportion of NYHA classⅠin the experimental group was higher than that of the control group(62.50%vs.12.50%,χ^(2)=21.333,P<0.001),and the proportion of NYHA classⅢwas lower than that in the control group(0 vs.25.00%,χ^(2)=11.429,P=0.001).The heart rate of the two groups decreased compared with that before treatment,and the experimental group was lower than that of the control group(P<0.01).LVEF in the two groups was higher than that before treatment,and LVEDD,LVESD decreased compared with those before treatment,and the increase/shrinkage in the experimental group were greater than those in the control group(P<0.01).The serum levels of NT-proBNP,hs-CRP,HBP and PCT in the two groups were lower than those before treatment,and the experimental group were lower than those in the control group(P<0.01).There was no significant difference in the incidence of adverse reactions b

关 键 词：急性心力衰竭 左西孟旦 达格列净 心功能 炎性因子 N末端脑钠肽前体 不良反应 

分 类 号：R541.6[医药卫生—心血管疾病]