达格列净联合沙库巴曲缬沙坦治疗急性射血分数降低型心力衰竭的疗效及其对患者血清心肌酶谱的影响

Efficacy of dapagliflozin combined with sacubitril valsartan in the treatment of heart failure with reduced ejection fraction and its effect on serum myocardial enzymes

目的:探讨达格列净联合沙库巴曲缬沙坦治疗急性射血分数降低型心力衰竭(HFrEF)的疗效及其对患者血清心肌酶谱的影响。方法:选取148例急性HFrEF患者为研究对象,根据治疗方式不同分为对照组与试验组,每组各74例。对照组患者予以沙库巴曲缬沙坦治疗;试验组予以达格列净联合沙库巴曲缬沙坦治疗,疗程均为7 d。比较两组患者疗效、心功能指标[左室射血分数(LVEF)、左心室收缩末期容积(LVESV)]、血清N末端脑钠肽前体(NT-proBNP)、血清心肌酶[进行肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)]水平和炎症因子[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)]水平及不良反应发生情况。结果:试验组患者治疗总有效率高于对照组的(91.89%vs.75.68%,P<0.05)。治疗后,试验组患者LVEF高于对照组(P<0.05),LVESV和NT-proBNP、cTnI、CK-MB、hs-CRP、IL-6及TNF-α水平低于对照组(P<0.05);两组不良反应发生率比较,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治疗能有效改善急性HFrEF患者心功能,降低心肌酶谱水平和炎症因子水平,疗效明显且安全。

Objective:To investigate the efficacy of dapagliflozin combined with sacubitril valsartan in the treatment of heart failure with reduced ejection fraction(HFrEF)and its effect on serum myocardial enzymes.Methods:A total of 148 patients with HFrEF were selected as the research subjects and divided into the control group and the experimental group according to the different treatment methods,74 cases in each group.The control group was treated with sacubitril valsartan,and the experimental group was treated with dapagliflozin combined with sacubitril valsartan.Both groups were treated continuously for 7 days.The curative effect,cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end systolic volume(LVESV)],serum N-terminal pro-brain natriuretic peptide(NT-proBNP),serum myocardial enzyme levels[troponin I(cTnI),creatine kinase isoenzyme(CK-MB)]and inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)],and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of treatment in the experimental group was 91.89%,which was higher than 75.68%in the control group(P<0.05).After treatment,LVEF in the experimental group was higher comparing with the control group(P<0.05),and LVESV,NT-proBNP,cTnI,CK-MB,hs-CRP,IL-6 and TNF-αlevels were lower than those in the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:For patients with acute HFrEF,dapagliflozin combined with sacubitril valsartan can effectively improve the cardiac function,reduce the levels of myocardial enzymes and inflammatory factors,with significant efficacy and good safety.