达格列净联合左西孟旦治疗老年射血分数减低型心力衰竭患者的效果

Effect of daggligin combined with levosimendan on elderly patients with heart failure with reduced ejection fraction

目的分析达格列净联合左西孟旦治疗老年射血分数减低型心力衰竭(heart failure with reduced ejection fraction,HFrEF)患者的效果。方法选取我院2019年7月至2022年7月老年HFrEF患者144例,随机分为研究组及对照组,每组72例。对照组给予左西孟旦,研究组在对照组基础上给予达格列净。统计两组治疗效果及不良反应发生情况,治疗前后检测心肌微循环指标[心肌缺血总负荷、ST段下降频次及持续时间]、氧化/抗氧化平衡指标[丙二醛(malondialdehyde,MDA)、超氧化物歧化酶(superoxide dismutase,SOD)、脂质过氧化物(lipid peroxide,LPO)、谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px)]。结果研究组总有效率95.83%,高于对照组86.11%(P<0.05)。治疗后,两组心肌缺血总负荷、ST段下降频次及持续时间、MDA及LPO均较治疗前明显降低,且研究组低于对照组(P<0.05);治疗后,两组血清SOD及GSH-Px高于治疗前,且研究组高于对照组(P<0.05)。研究组不良反应与对照组比较,差异无统计学意义(8.33%vs 5.56%,P>0.05)。结论达格列净联合左西孟旦治疗老年HFrEF患者疗效确切,安全、可靠,有助于纠正氧化/抗氧化平衡,改善心肌微循环。

Objective To analyze the effect of dapagliflozin combined with levosimendan in the treatment of elderly patients with heart failure with reduced ejection fraction(HFrEF).Methods A total of 144 elderly patients with HFrEF in our hospital from July 2019 to July 2022 were selected and randomly divided into the study group and the control group,with 72 cases in each group.The control group was given levosimendan,and the study group was given dapagliflozin on the basis of the control group.The treatment effects and adverse reactions of the two groups were compared.Myocardial microcirculation indexes[(total myocardial ischemia load,frequency and duration of ST segment decline)],oxidation/antioxidant balance index[malondialdehyde(MDA),superoxide dismutase(SOD),lipid peroxide(LPO),glutathione peroxidase(GSH-Px)]were detected before and after treatment.The both groups were followed up for 6 months and the readmission rate was counted.Results The total effective rate of the study group was 95.83%,which was higher than 86.11%of the control group(P<0.05).After treatment,the total myocardial ischemia load,frequency and duration of ST segment decline,MDA and LPO in the two groups significantly decreased compared with those before treatment,and those in the study group was lower than those in the control group(P<0.05).After treatment serum SOD and GSH-Px in the two groups were higher than those before treatment,and those in the study group were higher than those in the control group(P<0.05).There was no statistically significant difference in adverse reactions between the two groups(8.33%vs 5.56%,P>0.05).Conclusion Dapagliflozin combined with levosimendan is effective,safe and reliable in the treatment of elderly HFrEF patients,which is helpful to correct the oxidation/antioxidant balance and improve myocardial microcirculation.