达格列净联合沙库巴曲缬沙坦治疗慢性心力衰竭患者的效果

Effect of dapagliflozin combined with sacubitri valsartan in the treatment of patients with chronic heart failure

目的观察达格列净联合沙库巴曲缬沙坦治疗慢性心力衰竭患者的效果。方法回顾性选取2022年1月—2023年2月中国贵航集团三○二医院收治的慢性心力衰竭患者68例,根据治疗方法分为单一药物组(34例)和联合药物组(34例)。在常规基础治疗上,单一药物组采用沙库巴曲缬沙坦治疗,联合药物组采用达格列净联合沙库巴曲缬沙坦治疗,2组均持续治疗3个月。比较2组临床疗效,治疗前后心功能指标[左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室射血分数(LVEF)及6 min步行距离]、血浆N末端脑钠肽前体(NT-proBNP)水平、生活质量与自理能力评分,不良反应。结果联合药物组治疗总有效率为91.18%,高于单一药物组的70.59%(χ^(2)=4.660,P=0.031)。治疗3个月后,2组LVEDD、LVESD较治疗前缩小,LVEF较治疗前升高,6 min步行距离较治疗前延长,且联合药物组上述指标改善幅度均大于单一药物组(P<0.01);2组血浆NT-proBNP水平较治疗前下降,且联合药物低于单一药物组(P<0.01);2组明尼苏达心力衰竭生活质量量表(LHFQ)评分较治疗前降低,Barthel指数较治疗前升高,且相较于单一药物组,联合药物组LHFQ评分低,Barthel指数高(P均<0.01)。单一药物组和联合药物组不良反应总发生率比较,差异无统计学意义(11.76%vs.17.65%,χ^(2)=0.469,P=0.493)。结论慢性心力衰竭患者接受达格列净联合沙库巴曲缬沙坦方案治疗,有利于患者心功能、生活质量及自理能力改善,整体治疗有效性和安全性均较高。

Objective To observe the effect of dapagliflozin combined with sacubitri valsartan in the treatment of patients with chronic heart failure.Methods A total of 68 patients with chronic heart failure admitted to the China Guizhou Aviation Industry Group 302 Hospital from January 2022 to February 2023 were retrospectively enrolled,and they were divided into the single drug group(34 cases)and the combination drug group(34 cases).On the basis of conventional treatment,the single drug group was treated with sacubitril valsartan,and the combination drug group was treated with dapagliflozin combined with sacubitril valsartan,and both groups were continued treated for 3 months.The clinical efficacy,cardiac function indexes(LVEDD,LVESD,LVEF,6MWD),plasma NT-proBNP level,quality of life and self-care ability scores before and after treatment,and incidence of adverse reactions were compared betwent the two groups.Results The total effective rate of the combination drug group was 91.18%,which was higher than 70.59%of the single drug group(χ^(2)=4.660,P=0.031).After 3 months of treatment,LVEDD and LVESD were reduced,LVEF was increased,and 6MWD was prolonged in the two groups,and the improvement of the above indicators in the combination drug group was greater than that in the single drug group(P<0.01);The plasma NT-proBNP level of the two groups decreased compared with that before treatment,and the combination drug group was lower than that of the single drug group(P<0.01);The LHFQ score of the two groups decreased significantly,and the Barthel index increased compared with that before treatment(P<0.01).Compared with the single drug group,the LHFQ score of the combination drug group was lower,and the Barthel index was higher(P<0.01).There was no significant difference in the total incidence of adverse reactions between the single drug group and the combination drug group(11.76%vs.17.65%,χ^(2)=0.469,P=0.493).Conclusion The treatment of chronic heart failure with dapagliflozin combined with sacubitril valsartan is conducive to the improvement of cardiac function,quality of life and self-care ability of patients,and the overall treatment effectiveness and safety of this scheme are high.