沙库巴曲缬沙坦联合达格列净治疗射血分数减低型心力衰竭不伴糖尿病患者的临床效果分析

Clinical Effect of Sacubitril Valsartan Combined with Dapagliflozin in the Treatment of Patients with Heart Failure with Reduced Ejection Fraction without Diabetes Mellitus

目的观察不伴糖尿病(diabetic mellitus,DM)射血分数减低型心力衰竭(heart failure with reduced ejection fraction,HFrEF)患者治疗中应用沙库巴曲缬沙坦、达格列净的疗效。方法选取2021年1月—2023年6月于新沂市人民医院接受治疗的75例HFrEF不伴DM患者资料,以随机数表法分为两组,对照组37例、观察组38例,分别予以沙库巴曲缬沙坦、沙库巴曲缬沙坦+达格列净治疗。比较两组心功能、不良结局及不良反应发生情况。结果治疗后,观察组左室射血分数、舒张早期二尖瓣血流速度/舒张晚期二尖瓣血流速度(the ratio of early diastolic transmitral inflow velocity to late diastolic transmitral inflow velocity,E/A)值均高于对照组,差异有统计学意义(P<0.05);N末端B型利钠肽前体、左房内径、左室舒张末期内径为(1159.35±204.61)pg/mL、(39.12±2.64)mm、(58.52±2.34)mm,低于对照组的(1316.25±275.45)pg/mL、(42.26±3.56)mm、(61.03±2.51)mm,差异有统计学意义(t=2.805、4.347、4.481,P<0.05)。两组不良反应发生率对比,差异无统计学意义(P>0.05)。观察组再入院率、心血管病死率(18.42%、2.63%),低于对照组(21.62%、5.41%),差异无统计学意义(χ^(2)=0.120、0.001,P>0.05)。结论沙库巴曲缬沙坦+达格列净治疗HFrEF不伴DM可有效改善患者心功能,且不会增加不良反应及不良结局发生率。

Objective To observe the efficacy of application of sacubitril valsartan and dapagliflozin in the treatment of heart failure with reduced ejection fraction(HFrEF)patients without diabetes mellitus(DM).Methods 75 patients with HFrEF without DM who were treated in Xinyi People's Hospital from January 2021 to June 2023 were selected and grouped by randomized numerical table method,with 37 cases in the control group and 38 cases in the observation group,and they were treated with sacubitril valsartan,and sacubitril valsartan+dapagliflozin,respectively.Cardiac function,adverse outcomes and the occurrence of adverse reactions were compared between the two groups.Results After treatment,the left ventricular ejection fraction and the ratio of early diastolic transmitral inflow velocity to late diastolic transmitral inflow velocity(E/A)value of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).The N-terminal B-type natriuretic peptide precursor,left atrial internal diameter,and left ventricular end-diastolic internal diameter of the observation group were(1159.35±204.61)pg/mL,(39.12±2.64)mm and(58.52±2.34)mm,which were lower than those of the control group(1316.25±275.45)pg/mL,(42.26±3.56)mm and(61.03±2.51)mm,and the differences were statistically significant(t=2.805,4.347,4.481,P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The readmission rate and cardiovascular mortality rate in the observation group(18.42%,2.63%)were lower than those in the control group(21.62%,5.41%),and the differences were not statistically significant(χ^(2)=0.120,0.001,P>0.05).Conclusion Sacubitril valsartan+dapagliflozin in the treatment of HFrEF without DM can effectively improve the cardiac function of patients without increasing the incidence of adverse reactions and adverse outcomes.