达格列净联合沙库巴曲缬沙坦治疗非射血分数降低型心力衰竭的疗效及预后研究  

Study on efficacy and prognosis of dapagliflozin combined with sacubitril valsartan in treating non-reduced ejection fraction type heart failure

作　　者：杨小刚 邢建东 张芸 邢玉龙 YANG Xiaogang;XING Jiandong;ZHANG Yun;XING Yulong(Department of Cardiology,Gaochun People’s Hospital/Affiliated Gaochun People’s Hospital,Jiangsu Health Vocational College,Nanjing,Jiangsu 211300,China)

机构地区：[1]南京市高淳人民医院/江苏卫生健康职业学院附属南京市高淳人民医院心内科,南京211300

出　　处：《重庆医学》2025年第2期425-429,共5页Chongqing Medical Journal

基　　金：江苏卫生健康职业学院校级科研项目(JKB2021014)。

摘　　要：目的 研究达格列净联合沙库巴曲缬沙坦治疗非射血分数降低型心力衰竭(non-HFrEF)临床效果。方法 选取2022年1-12月在该院诊治的120例non-HFrEF患者作为研究对象,采用随机数字法分为观察组、对照组,每组各60例。两组患者均予β受体阻滞剂、利尿剂等常规治疗,对照组患者接受沙库巴曲缬沙坦(诺欣妥)治疗,观察组患者在对照组的基础上联合达格列净治疗,治疗时间为6个月。比较两组患者临床疗效,治疗前及治疗6个月后血清N末端B型利钠肽前体(NT-proBNP)、超敏-C反应蛋白(hs-CRP)、血肌酐(SCr)、血钾、心脏彩色多普勒超声参数、6 min步行试验(6MWT)距离,治疗期间主要心血管不良事件(MACE)发生情况。结果 治疗6个月后,观察组中总效率为93.3%,高于对照组的80.0%,差异有统计学意义(P=0.032)。治疗6个月后,两组NT-proBNP和hs-CRP水平较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗6个月后,两组LVEF、6MWT距离较治疗前升高,LVEDV、LVESV较治疗前降低,且观察组上述指标变化幅度大于对照组,差异有统计学意义(P<0.05)。观察组MACE发生率(16.7%)低于对照组(5.0%),差异有统计学意义(P<0.05)。结论 达格列净联合沙库巴曲缬沙坦治疗non-HFrEF可明显降低NT-proBNP、hs-CRP水平,改善心功能,提高运动耐量,降低MACE发生率,改善预后。Objective To investigate the clinical effect of dapagliflozin combined with sacubitril-valsartan in the treatment of non-reduced ejection fraction type heart failure(non-HFrEF).Methods A total of 120 patients with non-HFrEF diagnosed and treated in this hospital from January to December 2022 were selected as the study subjects and divided into the observation group and control group by the random number method,60 cases in each group.The both groups were treated with conventional treatments such asβ-receptor blockers and diuretics,the patients in the control group were treated with sacubitril-valsartan(Noxinto),and the patients in the observation group were treated with dapagliflozin on the basis of the control group for 6 months.The clinical efficacy,serum N-terminal B-type natriuretic peptide precursor(NT-proBNP),hypersensitivity-C-reactive protein(hs-CRP),serum creatinine(SCr),serum potassium,cardiac color Doppler ultrasound parameters,6 min walk test(6MWT)distance before treatment and in 6 months after treatment,and the occurrence of major adverse cardiovascular events(MACE)during treatment were compared between the two groups.Results After 6 months of treatment,the total effective rate in the observation group was 93.3%,which was higher than 80%in the control group,and the difference was statistically significant(P=0.032).After 6 months of treatment,the levels of NT-proBNP and hs-CRP in the two groups were significantly decreased compared with those before treatment,moreover the observation group was lower than the control group,and the difference was statistically significant(P<0.05).After 6 months of treatment,LVEF and 6MWT distance in the two groups were increased compared with those before treatment,LVEDV and LVESV were decreased compared with those before treatment,moreover the change amplitude of the above indexes in the observation group were greater than those in the control group,and the differences were statistically significant(P<0.05).The incidence rate of MACE in the observation group was lower

关 键 词：非射血分数降低型心力衰竭 沙库巴曲缬沙坦 达格列净 N末端B型利钠肽前体 6 min步行试验 主要不良心血管事件 

分 类 号：R541.6[医药卫生—心血管疾病]