达格列净联合沙库巴曲缬沙坦对心力衰竭的疗效分析

Analysis of Curative Effect of Dapagliflozin Combined with Sacubitril/Valsartan on Cardiac Function in Patients with Heart Failure

目的探讨达格列净联合沙库巴曲缬沙坦对缺血再灌注心力衰竭患者心功能及预后的影响。方法选取100例2020年10月至2022年9月于锦州医科大学附属三院心内科住院的急性心肌梗死缺血再灌注心力衰竭治疗患者,运用随机数字表法分为观察组(n=50)和对照组(n=50)。采集患者病历资料,在常规治疗的基础上,观察组予达格列净和沙库巴曲缬沙坦治疗,对照组予沙库巴曲缬沙坦治疗。治疗6个月后,比较两组内及两组间患者血肌酐(Scr)和血清胱抑素C(Cys-C),评估两组患者肾功能,比较两组内及两组间患者BNP(B型利钠肽)和超声心动图[左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、左心房舒张期内径(LAD)],评估两组患者心功能;比较两组内及两组间患者堪萨斯城心肌病患者生活质量量表评分(KCCQ),评估患者生活质量;出院1个月及治疗6个月后做6分钟步行试验(6MWT)和评估NYHA心功能分级,比较两组内及组间患者活动耐量和临床疗效;门诊随诊6个月,记录主要心血管不良事件MACE(包括:心衰再入院和心血管死亡)。结果临床疗效比较:治疗后观察组总有效率为97.80%,明显高于对照组的87.00%,差异有统计学意义(P<0.05);治疗后观察组患者心功能水平(LVEF、LVEDD、BNP、6MWD)、肾功能(Cys-C、Scr)和生活质量(KCCQ评分)均优于对照组,差异有统计学意义(P<0.05)。结论达格列净联合沙库巴曲缬沙坦可明显改善缺血再灌注心力衰竭患者临床症状和心功能,提升患者的生存质量,降低心衰再入院和不良心血管事件的发生率,改善临床预后。

Objective To investigate the effects of Dapagliflozin combined with Sacubitril/Valsartan on cardiac function and prognosis in patients with ischemia-reperfusion heart failure.Methods A total of 100 patients with acute myocardial infarction ischemia-reperfusion heart failure who were hospitalized in the Department of Cardiology of the Third Affiliated Hospital of Jinzhou Medical University from October 2020 to September 2022 were selected and divided into observation group(n=50)and control group(n=50)by random number table method.The medical records of the patients were collected.On the basis of routine treatment,the observation group was treated with Dapagliflozin combined with Sacubitril/Valsartan,and the control group was treated with Sacubitril/Valsartan.After 6 months of treatment,serum creatinine(Scr)and serum cystatin C(Cys-C)were compared within groups and between the two groups,and renal function was evaluated.B-type natriuretic peptide(BNP),echocardiography[left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)and left atrial diastolic diameter(LAD)]were compared within groups and between the two groups to evaluate the cardiac function of the two groups.Intra-group and inter-group KCCQ scores were compared to assess patients′quality of life.The 6-minute walking test(6MWT)and assessment NYHA cardiac function classification were performed on 1 month after discharge and 6 months after treatment to compare exercise capacity and clinical efficacy of patients within and between the two groups.Outpatients were followed up for 6 months,and major adverse cardiovascular events(MACE)(including heart failure readmission and cardiovascular death)were recorded.Results Clinical efficacy was compared:After treatment,the total effective rate of the observation group was 97.80%,which was significantly higher than that of the control group(87.00%),and the difference was statistically significant(P<0.05);after treatment,the cardiac function level(LVEF,LVEDD,BNP,6MWD),renal function(Cys-C,Scr)and quality of life(KCCQ score)in observation group were better than those in control group,and the difference was statistically significant(P<0.05).Conclusion Dapagliflozin combined with Sacubitril/Valsartan can significantly improve the clinical symptoms and cardiac function of patients with ischemia-reperfusion,improve the living quality of patients,reduce the incidence of adverse cardiovascular events,and improve the clinical prognosis.