恩格列净对急性心肌梗死后心力衰竭患者的疗效和安全性

Efficacy and safety of empagliflozin in patients with heart failure after acute myocardial infarction

目的探究恩格列净对急性心肌梗死(AMI)后心力衰竭(HF)患者的疗效和安全性。方法选取2022年6月至2024年1月景德镇市第一人民医院收治的72例AMI后HF患者,按随机数字表法分为两组,各36例。对照组男19例,女17例,年龄(62.18±6.19)岁,美国纽约心脏病学会(NYHA)分级Ⅱ级5例、Ⅲ级17例、Ⅳ级14例;恩格列净组男20例,女16例,年龄(62.33±6.21)岁,NYHA分级Ⅱ级6例、Ⅲ级18例、Ⅳ级12例。对照组行基础药物治疗,恩格列净组在此基础上加用恩格列净(10 mg/次,1次/d),治疗3个月。对比两组治疗效果、心功能指标[左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)]、6 min步行距离(6MWD)、心血管不良事件、不良反应。采用χ^(2)检验、t检验。结果恩格列净组总有效率[91.67%(33/36)]高于对照组[72.22%(26/36)](P<0.05)。治疗3个月后,两组LVEF、6MWD均升高,恩格列净组较对照组高,两组LVESD、LVEDD均降低,恩格列净组较对照组低(均P<0.05)。恩格列净组心血管不良事件发生率[5.56%(2/36)]低于对照组[22.22%(8/36)](P<0.05)。恩格列净组不良反应总发生率[22.22%(8/36)]与对照组[19.44%(7/36)]比较,差异无统计学意义(P>0.05)。结论恩格列净对AMI后HF患者有显著疗效,可改善患者心功能,降低心血管不良事件发生率,安全性较高。

Objective To investigate the efficacy and safety of empagliflozin in patients with heart failure(HF)after acute myocardial infarction(AMI).Methods A total of 72 patients with HF after AMI treated in Jingdezhen First People's Hospital from June 2022 to January 2024 were selected and were divided into two groups according to the random number table method,with 36 cases in each group.In the control group,there were 19 males and 17 females,aged(62.18±6.19)years,and the New York Heart Association(NYHA)grade was gradeⅡin 5 cases,gradeⅢin 17 cases,and gradeⅣin 14 cases.In the empagliflozin group,there were 20 males and 16 females,aged(62.33±6.21)years,including 6 cases of gradeⅡ,18 cases of gradeⅢ,and 12 cases of gradeⅣ.The control group was treated with basic drugs,and the empagliflozin group was additionally treated with empagliflozin(10 mg/time,once a day)for 3 months.The treatment effect,cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),and left ventricular end-diastolic diameter(LVEDD)],6-min walking distance(6MWD),cardiovascular adverse events,and adverse reactions were compared between the two groups.χ^(2)test and t test were used.Results The total effective rate of the empagliflozin group[91.67%(33/36)]was higher than that of the control group[72.22%(26/36)](P<0.05).After 3 months of treatment,the LVEF and 6MWD were increased in both groups,which were higher in the empagliflozin group than in the control group;the LVESD and LVEDD were decreased in both groups,which were lower in the empagliflozin group than in the control group(all P<0.05).The incidence of cardiovascular adverse events in the empagliflozin group[5.56%(2/36)]was lower than that in the control group[22.22%(8/36)](P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the empagliflozin group[22.22%(8/36)]and the control group[19.44%(7/36)](P>0.05).Conclusion Empagliflozin has significant efficacy in HF patients after AMI,which can improve the patients'cardiac function and reduce the incidence of cardiovascular adverse events,with high safety.