达格列净联合沙库巴曲缬沙坦片治疗心力衰竭患者的疗效及对其预后的影响

Efficacy and Prognosis of Dapagliflozin Combined with Sacubitril-Valsartan Tablets in the Treatment of Patients with Heart Failure

目的探讨达格列净联合沙库巴曲缬沙坦片治疗心力衰竭(HF)患者的疗效及对其预后的影响。方法选取2019年6月至2022年1月南召县卫生职业中等专业学校附属医院收治的89例HF患者为研究对象,按照随机数字表法分为单一组44例、联合组45例。单一组予以沙库巴曲缬沙坦片治疗,联合组在单一组基础上予以达格列净治疗。比较分析两组临床疗效及治疗前后心功能、心室重塑、凝血酶、心肌纤维化指标及生存情况。结果联合组治疗有效率(91.11%)高于单一组(75.00%);治疗后,联合组NT-pro BNP低于单一组,LVEF、CO高于单一组;治疗后联合组LVMI低于单一组,LVRI高于单一组;治疗后联合组凝血酶水平低于单一组;治疗后联合组TGF-β1、Col-I、Col-Ⅲ水平低于单一组;联合组HF再住院比例(7.14%)、HF病死比例(4.77%)低于单一组(30.00%、20.00%),差异有统计学意义(P<0.05),联合组与单一组心搏骤停比例(4.76%、7.50%)与全因死亡发生(7.14%、10.00%)比例比较,差异无统计学意义(P>0.05)。结论达格列净联合沙库巴曲缬沙坦片治疗HF患者疗效较好,可改善患者心功能,抑制心室重塑,降低凝血酶水平,改善心肌纤维化,且HF再住院率、病死率更低。

Objective To investigate the efficacy and prognosis of dapagliflozin combined with sacubitril-valsartan tablets in the treatment of patients with heart failure(HF).Methods A total of 89 HF patients admitted to the Affiliated Hospital of Nanzhao Health Vocational Secondary School from June 2019 to January 2022 were selected as the research objects,and divided into a single group of 44 cases and a combined group of 45 cases by random number table method.The single group was treated with sacubitril-valsartan tablets,and the combined group was treated with dapagliflozin on the basis of the single group.The clinical efficacy,cardiac function,ventricular remodeling,thrombin and myocardial fibrosis indexes before and after treatment were statistically compared and analyzed between the two groups.The survival of the two groups of patients was compared and analyzed.Results After treatment,the effective rate in the combined group(91.11%)was higer than that in the single group(75.00%);After treatment,NT-pro BNP in the combined group was lower than that in the single group,and LVEF and CO in the combined group were higher than those in the single group;After treatment,LVMI in the combined group was lower than that in the single group,and LVRI was higher than that in the single group;After treatment,prothrombin levels in the combined group were lower than those in the single group;After treatment,TGF-β1,Col-I and Col III levels in the combined group were lower than those in the single group;The proportion of rehospitalization for HF(7.14%)and death from HF(4.77%)in the combined group were lower than those in the single group(30.00%,20.00%),with statistically significant differences(P<0.05).There were no significant differences in the incidence of cardiac arrest(4.76%,7.50%)and all-cause death(7.14%,10.00%)between the combined group and the single group(P>0.05).Conclusion Dagliflozin combined with sakubatril valsartan tablets is more effective in treating patients with HF,improving their cardiac function,inhibiting ventricular remodeling,lowering prothrombin levels,improving myocardial fibrosis,and having lower rates of rehospitalization and morbidity and mortality in HF.