达格列净联合沙库巴曲缬沙坦治疗老年心力衰竭患者疗效及对血清NT-proBNP、hs-TnT水平的影响  

Efficacy of dapagliflozin combined with sacubitril/valsartan in treatment of elderly heart failure patients and its effect on levels of serum NT-proBNP and hs-TnT

作　　者：王少民 邓娣 付慧 Wang Shaomin;Deng Di;Fu Hui(Department of Geriatrics,Traditional Chinese Medicine Hospital of Bozhou City,Bozhou,Anhui,236800,P.R.China)

机构地区：[1]亳州市中医院老年医学科,安徽亳州236800

出　　处：《老年医学与保健》2025年第1期125-130,共6页Geriatrics & Health Care

基　　金：2021年第二批市重点研发计划项目(bzzc2021057)。

摘　　要：目的探究达格列净联合沙库巴曲缬沙坦治疗老年射血分数降低心力衰竭(HFrEF)患者疗效及对血清N末端B型钠尿肽前体(NT-proBNP)、超敏肌钙蛋白T(hs-TnT)水平的影响,为治疗该病症提供方法。方法回顾性选取2021年10月—2024年3月亳州市中医院收治的90例老年射血分数降低的心力衰竭(HFrEF)患者为研究对象,按照治疗方式不同分为观察组(n=45)和对照组(n=45)。2组均接受常规抗心衰治疗,对照组给予沙库巴曲缬沙坦治疗,观察组在对照组治疗的基础上加用达格列净治疗,治疗周期均为3个月。评估并比较2组治疗总有效率、Lee氏心衰积分、心功能指标值及血清NT-proBNP、hs-TnT水平;比较2组患者不良反应总发生率。结果观察组治疗总有效率高于对照组(91.11%vs 73.33%,P<0.05)。2组治疗后的Lee氏心衰积分较治疗前更低(P<0.05);且相较于对照组,观察组治疗后上述评分低于对照组(P<0.05)。2组治疗后左射血分数(LVEF)相较于治疗前均升高,左室舒张末期内径(LVEDD)和左室收缩期内径(LVESD)相较于治疗前均下降(P<0.05);且治疗后观察组LVEF相较于对照组更高,LVEDD和LVESD相较于治疗前更低(P<0.05)。2组治疗后血清NT-proBNP、hs-TnT水平相较于治疗前均下降(P<0.05);且治疗后观察组上述血清指标相较于对照组更低(P<0.05)。2组不良反应总发生率比较无统计学意义(P>0.05)。结论在老年HFrEF患者的治疗中,应用达格列净联合沙库巴曲缬沙坦治疗表现出了显著的疗效,能够有效缓解心衰症状,改善心功能,并且降低血清NT-proBNP和hs-TnT水平,同时具备较好的安全性。这一疗法显示出一定的临床应用前景和价值。Objective To investigate the efficacy of dapagliflozin combined with sacubitril/valsartan in the treatment of elderly heart failure patients with reduced ejection fraction(HFrEF)and its effects on the levels of serum N-terminal pro-B-type natriuretic peptide(NT-proBNP)and high-sensitivity troponin T(hs-TnT),and provide a therapeutic approach for this condition.Methods A retrospective study included 90 elderly HFrEF patients admitted to Traditional Chinese Medicine Hospital of Bozhou City from October 2021 to August 2023.They were divided into observation group(n=45)and control group(n=45)according to different treatment methods.Both groups received conventional anti-heart failure therapy.The control group was treated with sacubitril/valsartan,while the observation group was treated with dapagliflozin on the basis of the control group.All patients were treated for 3 months.The total clinical effective rate,Lee's heart failure scores,cardiac function indices[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)],levels of serum NT-proBNP and hs-TnT,and total incidence of adverse reactions were compared between the two groups.Results The total clinical effective rate in the observation group(91.11%)was higher than that in the control group(73.33%,P<0.05).After treatment,Lee's heart failure scores significantly decreased in both groups(P<0.05),and Lee's heart failure score in the observation group was lower than that in the control group(P<0.05).After treatment,LVEF increased significantly,while LVEDD and LVESD decreased significantly in both groups post-treatment(P<0.05),and the observation group demonstrated higher LVEF and lower LVEDD and LVESD compared with the control group(P<0.05).After treatment,the levels of serum NT-proBNP and hs-TnT decreased significantly in both groups(P<0.05),and the observation group was lower than the control group(P<0.05).There was no statistical significance in the total incidence of adverse reactions bet

关 键 词：老年 心力衰竭 达格列净 沙库巴曲缬沙坦 N末端B型钠尿肽前体 超敏肌钙蛋白T 

分 类 号：R54[医药卫生—心血管疾病]