达格列净对不伴糖尿病的心力衰竭患者血尿酸的影响  

Effects of dapagliflozin on serum uric acid in non-diabetic patients with heart failure

作　　者：林梦娇 LIN Mengjiao(Department of Cardiology,Harbin 242 Hospital,Harbin,150066,China)

机构地区：[1]哈尔滨二四二医院心血管内三科,哈尔滨150066

出　　处：《临床心血管病杂志》2025年第1期24-27,共4页Journal of Clinical Cardiology

基　　金：通用医疗科研基金(No:TYYLKYJJ-2022-025)。

摘　　要：目的:探讨达格列净对不伴糖尿病的心力衰竭患者血尿酸的影响。方法:选取2023年1月—2024年1月于哈尔滨二四二医院住院的心力衰竭合并高尿酸血症并不伴糖尿病患者200例,随机分为试验组(达格列净+心力衰竭标准治疗)和对照组(心力衰竭标准治疗),每组100例。记录两组患者治疗前后尿酸、氨基末端脑钠肽前体(NT-proBNP)和左室射血分数(LVEF)。随访6个月,观察痛风发作和不良事件发生情况。结果:治疗7 d和6个月后,对照组尿酸水平较治疗前均显著上升(均P<0.05),试验组尿酸水平较治疗前均显著下降(均P<0.05)。治疗6个月后,对照组LVEF改善不明显,NT-proBNP水平显著下降(P<0.05);试验组LVEF显著升高,NT-proBNP水平显著下降(均P<0.05)。随访期间,试验组痛风发生率显著低于对照组(4.2%vs 22.3%,P<0.05)。对照组和试验组均未发生低血糖、低血压、酮症酸中毒、急性肾损伤或肾功能损害等事件;与对照组相比较,试验组泌尿生殖系感染发生率升高(9.4%vs 2.1%,P=0.032)、心血管死亡率降低(0.06%vs 0,P=0.013)、住院率降低(25.5%vs 0.08%,P=0.002)。结论:达格列净整体安全性良好,能有效降低不伴糖尿病的心衰患者的血尿酸水平,减少痛风发作,降低心衰恶化风险,改善长期预后。Objective To investigate the effect of dapagliflozin on serum uric acid in non-diabetic patients with heart failure.Methods A total of 200 non-diabetic patients with heart failure combined with hyperuricemia who were be hospitalized in Harbin 242 Hospital from January 2023 to January 2024 were included.All patients were randomly divided into the experimental group(dapagliflozin and standard treatment of heart failure)and the control group(standard treatment of heart failure),100 patients in each group.The levels of uric acid,N-terminal pro-brain natriuretic peptide(NT-proBNP),and left ventricular ejection fraction(LVEF)before and after treatment in two groups were recorded.Followed up for 6 months to observe the occurrence of gout and adverse events.Results After 7 days and 6 months of treatment,the uric acid levels in the control group significantly increased compared to before treatment(both P<0.05),while in the experimental group significantly decreased(both P<0.05).In the control group,LVEF remained unchanged while NT-proBNP levels significantly decreased(P<0.05);The LVEF in the experimental group significantly increased,while the level of NT-proBNP significantly decreased(both P<0.05).During the follow-up,the incidence of gout in the experimental group was significantly lower than that in the control group(4.2%vs 22.3%,P<0.05).Neither group experienced adverse events such as hypoglycemia,hypotension,ketoacidosis,acute kidney injury,or renal function impairment.Compared with the control group,the incidence of urinary and reproductive system infections increased in the experimental group(9.4%vs 2.1%,P=0.032),cardiovascular mortality was lower(0.06%vs 0,P=0.013),and the hospitalization rate decreased(25.5%vs 0.08%,P=0.002).Conclusion Dapagliflozin demonstrated a favorable safety profile and effectively reduced the serum uric acid in non-diabetic patients with heart failure,reduce gout attacks,reduce the risk of heart failure worsening,and improve long-term prognosis.

关 键 词：心力衰竭 高尿酸血症 钠-葡萄糖协同转运蛋白-2 达格列净 

分 类 号：R541.6[医药卫生—心血管疾病]