达格列净联合曲美他嗪对冠心病并慢性心力衰竭患者左心室射血分数、6分钟步行距离影响研究

Study on the Effect of Dapagliflozin Combined with Trimetazidine on Left Ventricular Ejection Fraction and 6-Minute Walking Distance in Patients with Coronary Heart Disease Combined with Chronic Heart Failure

目的探讨达格列净联合曲美他嗪治疗冠状动脉粥样硬化性心脏病(简称冠心病)合并慢性心力衰竭(Coronary Heart Disease Combined with Chronic Heart Failure,CHF)的临床效果。方法随机选取2022年6月—2023年1月齐齐哈尔医学院附属第三医院心内科出院并随访的80例冠心病合并慢性心力衰竭患者,按照随机对照法分为对照组与研究组,每组40例。对照组患者口服达格列净治疗慢性心力衰竭,研究组患者口服达格列净联用曲美他嗪治疗慢性心力衰竭,两组患者连续用药6个月,比较两组患者治疗效果。结果治疗后,研究组总有效率95%高于对照组67.5%,差异有统计学意义(χ^(2)=9.921,P<0.05)。治疗后,研究组患者射血分数、心排血量、每搏量各项指标显著升高,左心室舒张末内径明显降低,优于对照组,差异有统计学意义(P均<0.05)。治疗后研究组的6 min步行距离显著高于对照组,差异有统计学意义(P<0.05)。结论达格列净联合曲美他嗪为冠心病并慢性心力衰竭的患者提供新的药物联合治疗方法,在提高患者的运动能力方面和提高生活质量方面等效果十分理想,提升了患者的治愈率。

Objective To investigate the clinical effect of dapagliflozin combined with trimetazidine in the treatment of coronary atherosclerotic heart disease complicated with chronic heart failure(CHF).Methods 80 patients with coronary heart disease combined with chronic heart failure(CHF)who were discharged from the Department of Cardiology of the Third Affiliated Hospital of Qiqihar Medical College and followed up from June 2022 to January 2023 were selected and divided into the control group and the study group according to the randomized control method,with 40 patients in each group.The patients in the control group were treated with oral dapagliflozin for chronic heart failure,and the patients in the study group were treated with oral dapagliflozin combined with trimetazidine for chronic heart failure.Patients in the two groups were treated with continuous medication for 6 months,and the therapeutic effect of the two groups was compared.Results After treatment,the total effective rate of the study group was 95%higher than that of the control group(67.5%),the difference was statistically significant(χ^(2)=9.921,P<0.05).After treatment,ejection fraction,cardiac output and stroke volume were significantly increased,and left ventricular end-diastolic inner diameter was significantly decreased in study groups,and were better than those in the control group,the differences were statistically significant(all P<0.05).The 6 min walking distance was significantly higher in the study group than in the control group after treatment,and the difference was statistically significant(P<0.05).Conclusion Dapagliflozin combined with trimetazidine provides a new drug combination therapy for patients with coronary heart disease and chronic heart failure,which is very effective in improving the patients'exercise capacity and improving the quality of life,and enhances the cure rate of the patients.