恩格列净对主动脉瓣置换术后糖尿病肾病患者左心室重构的逆转作用  

Reversal effect of empagliflozin on left ventricular remodeling in patients with diabetic kidney disease after aortic valve replacement

作　　者：王春柳 辛雨 李保银 邱冬夏 Wang Chunliu;Xin Yu;Li Baoyin;Qiu Dongxia(Department of Cardiovascular Surgery,General Hospital of the Northern Theater of Operations,Shenyang 110016,China;Department of Nephrology,General Hospital of the Northern Theater of Operations,Shenyang 110016,China;Department of Blood Purification,General Hospital of the Northern Theater of Operations,Shenyang 110016,China)

机构地区：[1]北部战区总医院心血管外科,辽宁沈阳110016 [2]北部战区总医院肾内科,辽宁沈阳110016 [3]北部战区总医院血液净化科,辽宁沈阳110016

出　　处：《实用药物与临床》2025年第2期111-115,共5页Practical Pharmacy and Clinical Remedies

摘　　要：目的探讨恩格列净对主动脉瓣置换术后糖尿病肾病患者左心室重构的逆转作用。方法收集2021年7月至2023年7月在北部战区总医院肾内科收治的因主动脉瓣狭窄(Aortic stenosis,AS)行主动脉瓣置换手术且合并2型糖尿病肾病的患者为研究对象,共160例。根据患者是否口服恩格列净将患者分为恩格列净组和对照组,比较两组之间的左心室质量(Left ventricular mass,LVM)、左心室质量指数(Left ventricular mass index,LVMI)、左心室舒张末期内径(Left ventricular end-diastolic diameter,LVEDd)、室间隔厚度(Interventricular septal thickness,IVST)、左心室后壁厚度(Left ventricular posterior wall thickness,LVPWT)、相对室壁厚度(Relative wall thickness,RWT)等相关指标。结果术后1周及术后3个月,两组患者LVM、LVMI、LVEDd、IVST、LVPWT、RWT指标比较,差异均无统计学意义(P>0.05)。术后6个月,恩格列净组的IVST、LVPWT、RWT与对照组相比,差异无统计学意义(P>0.05),而LVM[132.47(125.56,139.38)]、LVMI[104.65(98.97,110.33)]、LVEDd[41.68(38.44,46.60)]明显低于对照组的LVM[162.36(145.56,179.16)]、LVMI[114.45(101.53,127.37)]、LVEDd[45.43(43.06,47.80)],差异具有统计学意义(P<0.05)。恩格列净组术后3个月的LVM、LVMI、RWT较术后1周下降,且差异均具有统计学意义(P<0.05);术后6个月与术后3个月相比,左心室结构相关指标LVM、LVMI、LVEDd、IVST、LVPWT、RWT均有所下降,差异具有统计学意义(P<0.05)。对照组患者术后3个月与术后1周相比,上述指标变化并不明显,差异无统计学意义(P>0.05);术后6个月的LVM和LVMI较术后3个月降低,差异具有统计学意义(P<0.05)。结论恩格列净对主动脉瓣置换术后合并糖尿病肾病患者的左心室重构具有一定的积极影响,能够有效减轻左心室重构程度,为临床干预提供了新的治疗策略。Objective To investigate the reverse effect of empagliflozin on left ventricular remodeling in diabetic kidney disease(DKD)patients after aortic valve replacement.Methods Patients with aortic valve replacement,type 2 diabetes and DKD who were admitted to the Department of Nephrology of Northern Theater General Hospital from July 2021 to July 2023 due to aortic stenosis(AS)and complicated with type 2 DKD were collected as the study subjects.160 patients were divided into the empagliflozin group and the control group according to whether they took empagliflozin orally.Left ventricular mass(LVM),left ventricular mass index(LVMI),left ventricular end-diastolic diameter(LVEDd),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT)and relative wall thickness(RWT)were compared between the two groups.Results At 1 week and 3 months postoperatively,there were no statistically significant differences between the two groups in LVM,LVMI,IVST,LVPWT,or RWT(P>0.05).At 6 months postoperatively,there were no statistically significant differences in IVST,LVPWT,or RWT between the empagliflozin group and the control group(P>0.05).However,LVM[132.47(125.56,139.38)],LVMI[104.65(98.97,110.33)]and LVEDd[41.68(38.44,46.60)]in the empagliflozin group were significantly lower than those in the control group[LVM:162.36(145.56,179.16),LVMI:114.45(101.53,127.37),LVEDd:45.43(43.06,47.80)],with statistically significant differences(P<0.05).In the empagliflozin group,LVM,LVMI,and RWT showed significant reductions at 3 months postoperatively compared to 1 week postoperatively(P<0.05).Furthermore,left ventricular structural indicators LVM、LVMI、LVEDd、IVST、LVPWT、RWT decreased further at 6 months compared to 3 months postoperatively,with statistically significant differences(P<0.05).In the control group,there were no significant changes in these indicators between 1 week and 3 months postoperatively(P>0.05).LVM and LVMI significantly decreased at 6 months compared to 3 months postoperatively(P<0.05).Conclusi

关 键 词：主动脉瓣置换 恩格列净 糖尿病肾病 左心室重构 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学] R654.2[医药卫生—临床医学]