达格列净联合沙库巴曲缬沙坦钠治疗慢性心力衰竭患者的效果

Effects of Dapagliflozin combined with Sacubitril valsartan sodium in treatment of patients with chronic heart failure

目的:观察达格列净联合沙库巴曲缬沙坦钠治疗慢性心力衰竭患者的效果。方法:选取2019年4月至2022年12月该院收治的70例慢性心力衰竭患者进行前瞻性研究,按照随机数字表法将其分为对照组与研究组各35例。对照组口服沙库巴曲缬沙坦钠片治疗,研究组在对照组的基础上口服达格列净片治疗。比较两组临床疗效、治疗前后超声心功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)及左心室后壁厚度(LVPWD)]水平、血管内皮功能指标[血流介导的血管舒张功能(FMD)和硝酸甘油介导的血管舒张功能(NMD)]水平、血清炎性因子[超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平,以及不良反应发生率。结果:研究组治疗总有效率为94.29%(33/35),高于对照组的71.43%(25/35),差异有统计学意义(P<0.05);治疗2个月后,研究组LVEDD、LVPWD、hs-CRP、IL-6、TNF-α水平均低于对照组,LVEF、FMD、NMD水平均高于对照组,差异有统计学意义(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钠治疗慢性心力衰竭患者可提高治疗总有效率、心功能,抑制心室重构,改善血管内皮功能,减轻炎症反应,效果优于单用沙库巴曲缬沙坦钠治疗。

Objective:To observe effects of Dapagliflozin combined with Sacubitril valsartan sodium in treatment of patients with chronic heart failure.Methods:A prospective study was conducted on 70 patients with chronic heart failure admitted to the hospital from April 2019 to December 2022.They were divided into control group and study group according to the random number table method,35 cases in each group.The control group was treated with Sacubitril valsartan sodium tablets,while the study group was treated with Dapagliflozin tablets on the basis of that of the control group.The clinical efficacy,the ultrasonic cardiac function index levels before and after the treatment[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)and left ventricular posterior wall thickness(LVPWD)],the vascular endothelial function[blood flow-mediated vasodilation function(FMD)and nitroglycerin-mediated vasodilation function(NMD)],the serum inflammatory factor levels[high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]levels,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the study group was 94.29%(33/35),which was higher than 71.43%(25/35)of the control group,and the difference was statistically significant(P<0.05).After 2 months of treatment,the LVEDD,LVPWD,hs-CRP,IL-6 and TNF-αlevels of the study group were lower than those of the control group,the levels of LVEF,FMD and NMD were higher than those of the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Dapagliflozin combined with Sacubitril valsartan sodium can improve the total effective rate,improve the cardiac function,inhibit the ventricular remodeling,improve the vascular endothelial function and reduce the inflammatory reactions in the patients with chronic heart failure.Moreover,it is superior to single Sacubitril valsartan sodium treatment.