恩格列净联合rhBNP治疗射血分数降低型心力衰竭的疗效

Efficacy of empagliflozin combined with rhBNP in the treatment of heart failure with reduced ejection fraction

目的:探究恩格列净联合重组人脑利钠肽(rhBNP)治疗射血分数降低型心力衰竭(HFrEF)的疗效及对患者血清N-末端脑钠肽前体(NT-proBNP)、可溶性生长刺激表达基因2蛋白(sST2)和炎症因子的影响。方法:选取108例HFrEF患者为研究对象,根据治疗方式不同将患者分为对照组(n=54)和观察组(n=54)。对照组予以rhBNP治疗;观察组予以rhBNP联合恩格列净治疗。比较两组临床疗效及治疗前后心功能[左室射血分数(LVEF)、6 min步行试验(6MWT)、美国堪萨斯城心肌病患者生存质量表(KCCQ)]、心室重构[左室收缩末期内径(LVEDS)、左室舒张末期内径(LVEDD)]、血清NT-proBNP、sST2及炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、IL-6]水平。结果:观察组临床总有效率高于对照组(90.74%vs.74.07%,P<0.05)。治疗后,观察组LVEF、6MWT、KCCQ均高于对照组(P<0.05);LVEDS、LVEDD、NT-proBNP、sST2、TNF-α、IL-1β、IL-6水平均低于对照组(P<0.05)。两组不良反应发生率无统计学差异(P>0.05)。结论:恩格列净联合rhBNP治疗HFrEF的疗效和安全性均较好,可有效提高患者心功能,改善心室重构,降低血清NT-proBNP、sST和炎症因子水平。

Objective:To investigate the efficacy of empagliflozin combined with recombinant human brain natriuretic peptide(rhBNP)in the treatment of heart failure with reduced ejection fraction(HFrEF)and its effect on serum N-terminal pro-brain natriuretic peptide(NT-proBNP),soluble growth stimulating gene 2 protein(sST2)and inflammatory factors.Methods:108 patients with HFrEF were selscted as the research subjects.According to different treatment methods,they were divided into control group(n=54)and observation group(n=54).The former was treated with rhBNP,and the latter was treated with rhBNP combined with empagliflozin.The clinical efficacy and cardiac function[left ventricular ejection fraction(LVEF),6 min walking test(6 MWT),Kansas City Cardiomyopathy Quality of Life Questionnaire(KCCQ)],ventricular remodeling[left ventricular end-systolic diameter(LVEDS),left ventricular end-diastolic diameter(LVEDD)],serum NT-proBNP,sST2 and inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),IL-6]levels before and after treatment were compared between the two groups.Results:The total effective rate of the observation group was higher than that of the control group(90.74%vs.74.07%,P<0.05).After treatment,the LVEF,6 MWT and KCCQ of the observation group were higher than those of the control group(P<0.05).The LVEDS,LVEDD,NT-proBNP,sST2,TNF-α,IL-1βand IL-6 of the observation group were lower than those of the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The efficacy and safety of empagliflozin combined with rhBNP in the treatment of HFrEF are good,which can effectively improve the cardiac function,improve ventricular remodeling,and reduce the levels of serum NT-proBNP,sST and inflammatory factors.