达格列净对射血分数降低型心力衰竭患者血清氯离子及短期预后的影响

Effects of Dapagliflozin on serum chloride and short-term prognosis in patients with heart failure with reduced ejection fraction

目的观察达格列净对射血分数降低型心力衰竭(HFrEF)患者血清氯离子和短期预后的影响。方法选取2020年8月至2021年3月九江市第一人民医院收治的106例HFrEF患者作为研究对象,按照随机数字表法分为对照组和研究组,各53例。对照组予以西医临床常规诊疗,研究组则在对照组基础上予以达格列净口服治疗,连续干预3个月,比较治疗前后两组患者血清氯离子浓度和治疗结束6个月的预后状态。结果研究组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者血清氯离子水平高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.01)。研究组再住院率低于对照组,差异有统计学意义(P<0.01)。年龄、病程、基线美国纽约心脏病协会(NYHA)分级、治疗后氯离子水平和达格列净治疗是终点不良事件发生的影响因素(P<0.05)。logistic回归分析结果显示,病程是患者发生终点不良事件的危险因素(OR=1.586,P<0.05);治疗后氯离子水平是预防患者发生终点不良事件的保护因素(OR=0.924,P<0.05)。结论达格列净能够明显提高HFrEF患者临床治疗效果,通过改善患者血清氯离子水平,降低患者终点不良事件的发生风险,值得临床推广应用。

Objective To observe the effect of Dapagliflozin on serum chloride and short-term prognosis in patients with heart failure with reduced ejection fraction(HFrEF).Methods A total of 106 patients with HFrEF admitted to the First People's Hospital of Jiujiang from August 2020 to March 2021 were selected as research objects,they were divided into the control group and the study group according to random number table method,with 53 cases in each group.The control group received routine clinical diagnosis and treatment of western medicine,while the study group received Dapagliflozin oral therapy on the basis of the control group for 3 months.Serum chloride ion concentration before and after treatment and prognosis after 6 months'treatment were compared between the two groups.Results The total effective rate of treatment of the study group was higher than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the serum chloride ion levels in the two groups were higher than those before treatment,and the serum chloride ion level of study group was higher than that of the control group,and the differences were statistically significant(P<0.01).The rehospitalization rate in the study group was lower than that in the control group,and the difference was statistically significant(P<0.01).Age,disease duration,baseline New York Heart Association(NYHA)classification,post-treatment chloride level and Dapagliflozin treatment were the influencing factors for the occurrence of end-point adverse events(P<0.05).The logistic regression analysis showed that disease duration was a risk factor for end-point adverse events(OR=1.586,P<0.05).Chloride ion level after treatment was a protective factor for preventing the occurrence of end-point adverse events(OR=0.924,P<0.05).Conclusion Dapagliflozin can significantly improve the clinical treatment effect of patients with HFrEF.By improving the serum chloride ion level of patients,it can reduce the risk of adverse events in patients with end-point adverse events,which is worthy of clinical application.