达格列净治疗缺血性心肌病心衰的效果及对心功能的影响探讨

Application effect of dapagliflozin in the treatment of heart failure due to ischemic cardiomyopathy and its influence on cardiac function of patients

目的研究达格列净治疗缺血性心肌病心力衰竭(心衰)的效果及对心功能的影响。方法150例缺血性心肌病心衰患者,采用随机数字表法分为观察组和对照组,各75例。对照组患者采用常规抗心衰药物治疗,观察组在常规治疗基础上采取达格列净治疗。比较两组临床疗效、心血管不良事件(MACE)发生情况及治疗前后心功能指标[左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)和左心室收缩末期内径(LVESD)]、6 min步行距离、脑钠肽(BNP)水平。结果治疗前,两组LVEDD、LVEF、LVESD和6 min步行距离比较,差异无统计学意义(P>0.05);治疗后,观察组LVEDD(52.63±5.48)mm、LVESD(35.20±4.39)mm均小于对照组的(56.07±5.71)、(38.42±3.97)mm,LVEF(50.27±5.39)%高于对照组的(45.16±5.63)%,6 min步行距离(397.86±39.81)m长于对照组的(327.28±40.65)m,差异均有统计学意义(P<0.05)。治疗前,两组BNP水平比较,差异无统计学意义(P>0.05);治疗后,观察组BNP水平(1552.68±468.16)pg/ml低于对照组的(2487.95±527.25)pg/ml,差异有统计学意义(P<0.05)。观察组治疗总有效率为93.33%,高于对照组的81.33%,差异有统计学意义(P<0.05)。两组MACE发生率比较,差异无统计学意义(P>0.05)。结论对缺血性心肌病心衰患者予以达格列净治疗取得了较为理想的效果,对患者心功能指标的改善作用明显,且不会增加MACE,对患者的身体康复有积极作用。

Objective To study the effect of dapagliflozin in the treatment of heart failure due to ischemic cardiomyopathy and its influence on cardiac function of patients.Methods A total of 150 patients with heart failure due to ischemic cardiomyopathy were randomly divided into the observation group and the control group,with 75 patients in each group.Patients in the control group were treated with conventional anti heart failure drugs,and patients in the observation group were treated with dapagliflozin on the basis of conventional treatment.Both groups were compared in terms of clinical efficacy,occurrence of major adverse cardiovascular events(MACE),cardiac function indexes[left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),and left ventricular end systolic diameter(LVESD)],6-min walking distance,and brain natriuretic peptide(BNP)level before and after treatment.Results Before treatment,there was no statistically significant difference in LVEDD,LVEF,LVESD and 6-min walking distance between the two groups(P>0.05).After treatment,the LVEDD(52.63±5.48)mm and LVESD(35.20±4.39)mm in the observation group were less than(56.07±5.71)and(38.42±3.97)mm in the control group;the LVEF(50.27±5.39)% in the observation group was higher than(45.16±5.63)% in the control group;the 6-min walking distance(397.86±39.81)m in the observation group was longer than(327.28±40.65)m in the control group;the differences were all statistically significant(P<0.05).Before treatment,there was no statistically significant difference between the BNP levels of the two groups(P>0.05).After treatment,the BNP level(1552.68±468.16)pg/ml in the observation group was lower than(2487.95±527.25)pg/ml in the control group,and the difference was statistically significant(P<0.05).The total effective rate of treatment in the observation group was 93.33%,which was higher than 81.33% in the control group,and the difference was statistically significant(P<0.05).When comparing the incidence of MACE in the two groups,the difference was not statistically significant(P>0.05).Conclusion In the clinical treatment of patients with heart failure due to ischemic cardiomyopathy,dapagliflozin treatment has achieved satisfactory results,significantly improved cardiac function indexes without increasing MACE.It has a positive effect on the patient’s physical recovery.