诺欣妥标准治疗基础上加用达格列净治疗射血分数保留心力衰竭的临床获益机制研究

Clinical Benefit Mechanism Study of Dapagliflozin Addition on ths Basis of Nuoxintuo Standard Therapy in the Treatment of Heart Failure with Preserved Ejection Fraction

目的:探讨沙库巴曲缬沙坦钠片(商品名:诺欣妥)标准治疗基础上加用达格列净治疗射血分数保留心力衰竭(HFpEF)的临床获益机制。方法:选取2022年6月—2023年2月茂名市中医院收治的HFpEF患者80例为研究对象,根据随机数字表法分为单药组与联合组,各40例。单药组接受沙库巴曲缬沙坦钠片标准治疗,联合组加用达格列净治疗。比较两组临床疗效、血糖、身体质量指数(BMI)、心功能、炎性及应激指标。结果:联合组临床疗效总有效率高于单药组,差异有统计学意义(P=0.001);治疗后,两组空腹血糖、糖化血红蛋白、餐后2h血糖、BMI均降低,联合组低于单药组,差异有统计学意义(P<0.05);治疗后,两组左心室质量指数、左心房容积指数、二尖瓣口舒张早期流速、二尖瓣环舒张早期运动速度均降低,联合组低于单药组,差异有统计学意义(P<0.05);治疗后,两组血清白细胞介素-6、肿瘤坏死因子-α、超氧化物歧化酶、丙二醛水平均降低,联合组低于单药组,差异有统计学意义(P<0.05)。结论:沙库巴曲缬沙坦钠片标准治疗基础上加用达格列净可以提高HFpEF患者的临床效果,降低血糖水平,改善BMI和心功能,减轻炎性反应和应激反应。

Objective:To investigate the clinical benefit mechanism of dapagliflozin addition on ths basis of sacubactril valsartan sodium tablets(brand name:Nuoxintuo)standard therapy in the treatment of heart failure with preserved ejection fraction(HFpEF).Methods:Eighty patients with HFpEF treated in Maoming Hospital of Traditional Chinese Medicine from June 2022 to February 2023 were selected as the study objects,and were divided into single-drug group and combined group according to random number table method,with forty cases in each group.The single-drug group received standard treatment with sacubactril valsartan sodium tablets,and the combined group added dapagliflozin.The clinical efficacy,blood glucose,body mass index(BMI),cardiac function,inflammation and stress indexes were compared between the two groups.Results:The total effective rate of clinical effect of combined group was higher than that of single-drug group,the difference was statistically significant(P=0.001);after treatment,fasting blood glucose,glycated hemoglobin,2 h postprandial blood glucose and BMI in two groups were decreased,and the combined group was lower than the single-drug group,the difference was statistically significant(P<0.05);after treatment,left ventricular mass index,left atrial volume index,early mitral valve diastolic velocity and early mitral ring diastolic motion velocity were decreased in two groups,the combined group was lower than single-drug group,and the difference was statistically significant(P<0.05);after treatment,serum levels of interleukin-6,tumor necrosis factor-α,superoxide dismutase and malondialdehyde in two groups were decreased,and the combined group was lower than that of single-drug group,with statistical significance(P<0.05).Conclusion:Dapagliflozin addition on ths basis of sacubactril valsartan sodium tablets can improve the clinical effect of HFpEF patients,reduce blood glucose levels,improve BMI and cardiac function,and alleviate inflammatory response and stress response.